Planning for safe childbearing

Antenatal care

Good antenatal care should identify and address potential problems at the earliest point in the pregnancy thereby minimising risk to the woman and fetus.

Guidelines published by the National Institute for Health and Clinical Excellence (NICE) 'Antenatal care: routine care for the healthy pregnant woman' provides advice on:

• the routine care that all healthy women can expect to receive during their pregnancy.

Planning for labour

During pregnancy the midwife and obstetrician should, with the woman, discuss potential risk factors and agree a planned course of action for pregnancy and birth. Early involvement by the obstetrician is essential where risks factors for obstetric haemorrhage are identified. Additionally the Consultant Haematologist should be approached for advice on management of women with pre-existing haematological disorders, e.g. sickle cell disease, antibodies (anti-D and others) or coagulation deficiencies, woman who have a history of repeated transfusions and for women who do not respond to treatment of antenatal anaemia.

The birth planning process should consider place and mode of delivery where there are risk factors for haemorrhage. This should be discussed with and agreed by the woman. The agreed plan should be clearly documented in the antenatal care record.

The published NICE guidelines,'Intrapartum care: Care of healthy women and their babies during childbirth' provides information on risk factors that inform decisions on place and mode of delivery.

The Handbook of Transfusion Medicine provides guidelines for the management of Obstetric haemorrhage.

This page was last reviewed on 02/08/2010