Intrapartum Care: Care of Healthy Women and Their Babies During Childbirth

Intrapartum Care: Care of Healthy Women and Their Babies During Childbirth

Birth is a life­changing event and the care given to women has the potential to affect them both physically and emotionally in the short and longer term.

This guideline covers the care of healthy women in labour at term (37–42 weeks of gestation). About 600 000 women give birth in England and Wales each year, of whom about 40% are hav ing their first baby.1,2 Most of these women are healthy and have a straightforward pregnancy.

Features: Used Book in Good Condition Disorders of menstruation are among the most common problems encountered in womens' health and include early, delayed and irregular menstrual cycles, painful menses and excessive menstrual bleeding, and early menopause. Their treatment presents a variety of complex challenges, especially since some of the treatments used can themselves result in further menstrual and hormonal complications.   This text provides a comprehensive review of our current knowledge of the causes of these conditions, their investigation, and the treatment options available. It has been designed as a practical reference for the doctors' office or clinic, presenting the physician with a detailed account of how to assess the patient and then determine the most appropriate course of treatment, which may extend beyond pharmacologic interventions to surgery. Practice points conclude each section and summarize the most important clinical and management issues.

Almost 90% of women will give birth to a single baby after 37 weeks of pregnancy with the baby presenting head first. Most women (about two­thirds) go into labour spontaneously. Thus the majority of women giving birth in the UK fall under the scope of this guideline.
More than 90% of births take place in designated consultant wards or combined consultant/GP wards. In England in 2002–2003, 1% of births took place in GP wards, 3% in midwife wards and 2% at home.3.

An estimated 47% of births were described as ‘normal births’ in England in 2002–2003. Normal birth is defined as that without surgical intervention, use of instruments, induction, or epidural or general anaesthetic.3
In total, 22% of births in England in 2002–2003 were by caesarean section and about 11% were instrumental births, including forceps or ventouse. Instrumental births were associated with a longer hospital stay in England and Wales in 2002–2003.3

About one­third of women had an epidural, general or spinal anaesthetic during labour in England in 2002–2003.3 The importance of effective communication between women and caregivers during intrapartum care has been identified by the GDG as one of the most important themes that runs through the guideline.

To facilitate good practice and the implementation of this issue, the GDG has devel oped ‘recommendations on implementing good communication’ at important points within the guideline.

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