‘Woman-centred care’ is the term used for a philosophy of maternity care that gives priority to the wishes and needs of the user, and emphasises the importance of informed choice, continuity of care, user involvement, clinical effectiveness, responsiveness and accessibility. All four countries of the UK introduced policies for maternity services reform in the early 1990s that aimed to make the planning and delivery of maternity care more responsive to women’s own needs and wishes, and to improve women’s ability to make informed choices about many aspects of their care (Department of Health, 1993; Department of Health and Social Services Northern Ireland, 1994; Scottish Office, 1993; Welsh Office, 1991). These policies are still in place and have the support of the current Government, but they have been overtaken by new health policies and priorities. This paper sets out the RCM’s position on woman-centred care.

This paper provides guidance for midwives on issues relating to the administration of Vitamin K to the newborn. The Department of Health recommends that all newborn babies should receive an appropriate Vitamin K regimen, to be agreed with the parents’ informed consent. The RCM urges midwives to ensure that all parents are supported to reach their own informed decision on whether their infant should be given Vitamin K orally, intramuscularly, or not at all. It reminds midwives of their need to comply with legal requirements in the administration of Vitamin K, and calls for further research into the efficacy and safety of routine prophylactic administration of Vitamin K.

This position paper gives support to increased collaboration and integration of midwives into the public health sector of health care.

Over the last two generations, home birth in the UK has become markedly less common (Chamberlain et al, 1997). Yet the evidence indicates that the health outcomes of planned home birth are as good as those for hospital birth, and that many women experience a range of emotional and practical benefits from giving birth at home (Enkin et al, 1995).

Increasing numbers of women are choosing to have a child outside of a heterosexual relationship, and some of them may have a female partner. This raises significant implications for midwives, whose practice addresses women’s emotional, social and family needs as well as their physical needs, as we may not know what the needs of these women are.

This position paper explains the current policy context for action on racism in maternity services, offers guidance on developing services that are more responsive to the needs of black and ethnic minority women and urges greater efforts to tackle racial discrimination and racial harassment in the workplace.

Herpes is an important reproductive health problem. For those with symptoms it is often a stigmatized condition. Obstetric and paediatric staff must relate to the condition and risks for the newborn child. Neonatal herpes is a serious consequence of genital herpes virus infection. The risk of transmission in and around delivery is less than one percent in women with longstanding infection, but it is said to be substantially higher, if the maternal infection is acquired during late pregnancy. Untreated herpes infection has among the highest mortality of any infection in the neonatal period and neurological afflictions are common among the survivors.

Immersion in water during labour was popularised as a formal method of analgesia by Odent in the 1970s (Beake 1999), and became widespread after the Winterton Report recommended that all maternity services provide women with the option to labour or deliver in water (House of Commons Health Committee, 1992). As with all aspects of midwifery care, the use of water during labour and birth requires evaluation of associated benefits and risks, yet there are no large, collaborative, randomised controlled trials to date (Nikodem, 2000). This paper clarifies the RCM’s position and recommendations to its members. It should be used in conjunction with local policies and guidelines.

The past 20 years has seen limited improvements in the initiation and duration of breastfeeding rates, with only a very small proportion of infants being breastfed exclusively at 6 months of age in the UK. In 2000, only 69% of mothers in the UK initiated breastfeeding with only 28% continuing on to four months and 21% at six months. This situation is due to a number of factors such as inadequate training and knowledge of health care professionals, inconsistent advice, the exploitation of mistaken cultural and health beliefs, non-supportive environments for breastfeeding at work and in public places and aggressive marketing of breast milk substitutes. The evidence also shows that many women give up breast-feeding before they would like to because of lack of support in dealing with problems encountered.

Increasingly, people with learning or physical disabilities, or chronic ill health, are using the maternity services. Whatever the nature or extent of their disability, they are looking to midwives to provide the individualised, holistic woman-centred care that they need to enjoy their pregnancy and delivery, and make an effective transition to parenthood.

The aim of this guidance is to provide clinicians with up-to-date, evidence-based information on the diagnosis and treatment of malaria in pregnancy, in situations that are likely to be encountered in UK medical practice. For initial rapid assessment and management, see Appendix 1 of the guideline.

Guidance and procedure for Ankyloglossia (tongue-tie).

It is estimated that around 5% of the pregnant population (approximately 30 000 women per annum in the UK) are offered a choice of invasive prenatal diagnostic tests (most commonly amniocentesis or chorionic villus sampling). The type of diagnostic test available and offered is likely to vary depending upon the timing of any initial screening test that is performed. The aim of this guideline is to set a series of evidence-based standards to ensure a high level and consistency of practice in the provision and performance of amniocentesis and chorionic villus sampling.

This guideline covers the care of healthy women in labour at term (37–42 weeks).

This document is a compilation of generic and disease-specific standards for antenatal screening for infectious diseases.

With changing social relations and advances in medical technology, midwives are increasingly faced with women whose route to motherhood might be labelled as ‘unconventional’. Whilst surrogacy arrangements remain rare, there is some evidence that such arrangements are becoming more frequent.

This paper provides guidance for health professionals working in sexual and reproductive health, general practice, and obstetric and gynaecology settings. It provides information on the sexual and reproductive health of individuals with inflammatory bowel disease (IBD).

The best practice statement routine examination of the newborn was originally developed in 20041 by a project midwife seconded to the Practice Development Unit of NHS QIS together with a multiprofessional working group. The aim of the statement is to offer guidelines for all registered maternity care professionals undertaking the routine examination of newborn babies, and is based on the evidence currently available together with a consensus by experts of established practice. The statement was reviewed and updated by a working group in 2008. In addition to the review process, an audit tool has been developed to support registered maternity care professionals and organisations who would like to audit current local practice. Babies are inspected soon after birth to identify any obvious visible unexpected features or abnormalities and to reassure parents. The midwife in attendance at the birth usually conducts this initial inspection. It is established as good practice to carry out a more detailed examination of the baby within 24 hours of birth as part of the core health programme for under five’s.2 During this routine examination problems can be identified, and if appropriate referred for investigation, specialist assessment and treatment, as well as being fully discussed with the parents.

This paper provides guidance and information for clinicians and women considering the use of contraception while breastfeeding.

Toxoplasma gondii occurs world-wide and is one of the most common parasitic infections in humans. Infection is acquired by ingestion of viable tissue cysts in undercooked meat, or of oocysts excreted by cats and contaminating soil or water1;2. In this paper the feasibility, effectiveness and appropriateness of introducing prenatal or neonatal screening for congenital toxoplasmosis is evaluated, based on the criteria set out for the assessment of a screening programme by the UK National Screening Committee.