In This Section
There is a well established research literature on women’s experiences of labour and birth, and there is growing evidence on what matters to different groups of women and partners. The epidemiological evidence looks at different populations of women and babies and the clinical effects for them of different patterns of antenatal care, place of birth and mode of birth. NCT approaches pregnancy, labour, birth and postnatal care from a biopsychosocial perspective, asking about the emotional and social effects of different experiences as well as the biological (physical) and clinical effects.
For example, there has been relatively little focus on the effects for babies of different ways of managing spontaneous labour and birth. NCT has contributed to a Cochrane overview of systematic reviews on pain management for women in labour. This has moved the research agenda forward by asking how many studies have investigated the effect of opioids for pain relief during labour on babies’ feeding behaviour after birth.
NCT has used social and public health research to inform NCT’s birth policy and information on intrapartum care, normal birth and other modes of birth, place of birth, and women and men’s experiences.
As well as evidence-based clinical guidance from NICE on intrapartum care, induction of labour and other topics, and systematic reviews of evidence from the Cochrane Collaboration, a range of policy documents and briefings drawing on evidence are available from government and other public bodies. These are highlighted below with links to the relevant publication.
Government and public bodies
Saving mothers' lives: reviewing maternal deaths to make motherhood safer: 2006-2008. The Eighth Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom (2011), published by the Centre for Maternal and Child Enquiries (CMACE), shows that between 2006 and 2008 there were 261 deaths in the UK which related directly or indirectly to pregnancy. The overall maternal mortality rate was 11.39 per 100,000 maternities. Direct deaths have decreased and for the first time there has been a reduction in the inequalities gap, with a significant decrease in maternal mortality rates among those living in the most deprived areas and those in the lowest socio-economic group. Despite a decline in the overall UK maternal mortality rate, there has been an increase in deaths related to genital tract sepsis which is now the most common cause of direct maternal death.
Safer Childbirth: Minimum Standards for the Organisation and Delivery of Care in Labour was published in 2007 by the Royal College of Obstetricians and Gynaecologists (RCOG). The report focuses on improving the safety and quality of maternity by ‘clearly setting out informed and considered views about the essential minimum staffing standards required to support women in labour and provide safe care for them and their babies’. An NCT document summary of this report is available as a 'related document' below.
In 2009 the information service for the NHS in Scotland published Trends in perinatal mortality in Scotland: a review over 30 years on the trends in perinatal and infant mortality and morbidity over the previous 30 years. The aim of this report is to explore whether routinely collected data can be used to highlight any areas of concern and to suggest areas for further monitoring, analysis and reporting. It does not attempt to engage in detailed statistical analysis.
NHS Quality Improvement Scotland (NHS QIS) reproductive health programme published annual reports on Scottish perinatal and infant mortality and morbidity until April 2011 when Healthcare Improvement Scotland took over the responsibilities of NHS QIS.The most recent report is the Scottish perinatal and infant mortality and morbidity report 2009.