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).

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.

‘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 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.

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

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.

The Department of Health (DH) asked the National Institute for Health and Clinical Excellence (NICE or the Institute) to produce public health guidance to improve the nutrition of pregnant and breastfeeding mothers and children in low-income households. In particular, this guidance addresses disparities in the nutrition of low-income and other disadvantaged groups compared with the general population.

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.

Guidance and procedure for Ankyloglossia (tongue-tie).

This document acknowledges that many childbearing women are becoming increasingly interested in the use of complementary and alternative therapies during pregnancy, childbirth and the postnatal period. It also stresses the importance of understanding the risks and benefits of these therapies and how they relate to midwifery care.

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

The RCM believes it is the responsibility of every employer to make effective provision to ensure the safety of midwives working in the community. Midwives are the only health professionals with a legal requirement to attend childbearing women, whatever the setting and whatever the risks. With the increasing emphasis on continuity of carer and community-based care, many more midwives are making regular late night visits. These guidelines have been designed to protect midwives as they deliver care.

Vasa praevia is a recognised cause of fetal intrapartum death first recognised clinically and reported upon in 1801. There is a high fetal mortality associated with rupture of the vasa praevia, with death resulting from rapid and catastrophic fetal exsanguination. Early detection is desirable as planned caesarean section can circumvent the risks.

This document presents recommendations for the management of pregnant women with diabetes--to be used in conjunction with usual obstetric practice.

This paper proposes a set of guidelines for the screening and early detection of pre-eclampsia in the community. It also provides a framework for referral thresholds and assessment procedures.

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

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.

In every area there should be an effective multi-disciplinary maternity services forum, where commissioners, providers and users of maternity services bring together their different perspectives in partnership to plan, monitor and improve local maternity services. In many areas a maternity services liaison committee (MSLC) has become well established which provides this function.

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.