One-to-one midwifery care NCT Position Statement Position statement One-to-one midwifery care in labour
Government policy for maternity services in England1 contains a commit-
ment to ‘continuity of midwifery care [which] will include … providing indi-
vidual support to women throughout their labour and birth’; the Keeping
Childbirth Natural and Dynamic (KCND) programme in Scotland2 supports
one-to-one care during first and second stages of labour; and the National Service Framework for Children, Young People and Maternity Services in Wales3 sets a standard for ‘Women to receive one-to-one care (one
woman receiving the dedicated time of a midwife) once labour is estab-
NCT supports these policies and a style of care for women, whether they
are perceived to be at high or low risk of complications, where during preg-
nancy they can get to know the midwife who is likely to look after them in
labour. If this has not been possible, it is highly desirable that one midwife
carries out the care so that the woman and her partner are not required to
meet and form relationships with strangers once labour is established.
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When the Healthcare Commission carried out a survey in 2007, they found
that 26% of women ‘were left alone during labour at a time when it worried
them to be alone’.4 The NCT expressed concern at that time and urged
NHS trusts to ensure that midwives spend as much time as possible on one-to-one care and support.
NCT is a registered charity (England &
The advantages of continuous, one-to-one care during labour are numer-ous, and they include:
Consistent, sensitive, non-intrusive support and encouragement for the woman in labour, where the midwife knows her wishes and her planned approach to the birth, without having to ask questions or require the cou-ple to repeat explanations The maintenance of a quiet and private environment, without the disrup-tion of people coming and going, where the woman’s labour can progress without distraction and she can concentrate on her own capacity to give birth spontaneously without pharmaceutical pain relief and intervention In the unusual event of a complication arising during labour, a midwife familiar with the progress of labour and the woman’s reactions will be more easily able to detect problems, discuss any need for referral or in-tervention with the woman and her partner, and if necessary take such action A reduced chance of infection for mother or baby as the number of atten-dants is kept to a minimum.
NCT urges health services to implement fully the national policies of mater-nity care that have continuous, one-to-one support in established labour at their heart. The investment in this area will result in more normal births, a reduction in invasive and expensive intervention, greater satisfaction for both mother and midwife, and higher breastfeeding rates as women come through the birth experience feeling empowered, well supported and confi-dent to care for their babies.
Use of misoprostol NCT Position Statement References
1. Department of Health. Maternity matters: choice, access and continuity of care in a safe service. London: Department of Health; 2007.
2. Scottish Executive. A framework for maternity services in Scotland. Scottish
3. Welsh Assembly Government. National Service Framework for Children, Young People and Maternity Services in Wales. Cardiff: Welsh Assembly Government;
4. Towards better births: A review of maternity services in England. Jan 2008. Healthcare Commission. www.cqc.org.uk/publications.cfm?fde_id=625
For more information visit www.nct.org.uk
NCT, Alexandra House, Oldham Ter-race, London W3 6NH
NCT is a registered charity (England &
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Jake Olivier, Ph.D. PEER-REVIEWED JOURNAL ARTICLES * Supervision of student or post-doc in underline 1. Heinzelmann-Schwarz VA, Nixdorf S, Valadan M, Diczbalis M, Olivier J , Otton G, Fedier A, Hacker NF & Scurry JP. A clinicopathological review of 33 patients with vulvar melanoma identifies c-KIT as a prognostic marker. International Journal of Molecular Medicine , accept