Guidance for Antenatal and

Postnatal Services in the evolving

Coronavirus (COVID-19) pandemic

Information for healthcare professionals

Version 3: Published Wednesday 21 October 2020

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Table of updates
A summary of previous updates can be found on pages 14–15.

Version Date Summary of changes

3 21.10.20 Throughout: Replaced ‘face-to-face’ with ‘in-person’ to clarify that video

consultations are not a direct replacement for in-person review.
3 21.10.20 Throughout: Rewording for clarity; document reviewed as current with
reference to current (as of 1.10.2020) public health guidance in UK
nations.
3 21.10.20 Throughout: The overall recommendation is that NICE - recommended
schedules of antenatal and postnatal care should be provided wherever
possible. This is emphasised throughout the document, with areas for use
of virtual appointments if necessary highlighted.
3 21.10.20 0 Introductory note: Added for autumn 2020
3 21.10.20 2: Modification to advice “When reorganising services, maternity
services should be cognisant of evidence that black, Asian and minority
ethnic group (BAME) individuals, women living in areas of multiple
deprivation, and women with pre-existing comorbidities are at particular
risk of developing severe and life-threatening COVID-19.”
3 21.10.20 2.2: Providing in-person consultations safely: Updated to refer to
current isolation guidelines for either 10 or 14 days.
3 21.10.20 3.6: Recommendation added: ‘Antenatal education Services, where they
have not already done so, should seek to provide remote antenatal
education classes. Remote antenatal classes may continue as in-
person classes are re-introduced, as they may be more accessible and
acceptable for some women.’
3 21.10.20 4.1: Reference made to further information about safely providing
virtual consultations, which can be found in the RCM’s briefing and the
accompanying poster.
3 21.10.20 4.1: Recommendations modified and added:
• The NICE Schedule of Antenatal Care should be maintained in its
entirety.
• If modifications to the pre-pandemic antenatal schedule are
unavoidable, suggested modifications to the existing schedule of
antenatal care for low risk women, including where in-person
appointments might be replaced with remote assessments are
detailed in the table in 4.1.

• In line with recommendations made in RCOG/RCM guidance

‘Coronavirus infection and pregnancy’, all women should
be asked about their mental wellbeing at every appointment.
Where a woman identifies that she is experiencing psychological
distress including high levels of anxiety or depression, additional
appropriate support should be instigated as rapidly as possible.
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3 21.10.20 4.1.1: Table in section 4.1.1 modified to identify appointments for low
risk women suitable to be provided virtually.
3 21.10.20 3.1.1: Additional section added: ‘Supporting the development of trusting
relationships’.
3 21.10.20 5 Postnatal care:
Recommendations modified
• Postnatal care should be individualised according to the woman
and newborn’s needs and should follow the NICE guidance for
postnatal care as far as possible
• Visits on day 1 at home, and day 5 for the newborn blood spot
should be prioritised as in-person visits

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Introductory note: Autumn 2020
As the pandemic situation evolves, those charged with leading maternity services will once
more be reflecting on antenatal and postnatal service provision. The challenges are, as in the
spring, increases in local infection prevalence and the risk of nosocomial transmission, increases
in staff absence and self-isolation and resulting service pressures.

It is now clear that for the 700 000 women who have or will give birth in the UK between
March 2020 and March 2021, the majority or all of their care will occur under some form of
coronavirus-induced restriction. To these women, this is not a temporary change, but their
whole pregnancy and birth experience. It is, therefore, essential that we do everything we can
to optimise the physical and mental wellbeing of pregnant women and new parents, while
maintaining adherence to social distancing and reducing as far as possible the potential for
nosocomial transmission.

The document below continues to provide guidance on using a flexible approach to

modifications to antenatal and postnatal services. Recommendations should be interpreted in
the context of local infection rates and service pressures.

1. Introduction
This guidance is for antenatal and postnatal services to support them during the evolving
coronavirus pandemic. This document intends to outline which elements of routine antenatal
and postnatal care are essential and which could be modified, given national recommendations
for social distancing to reduce transmission between women, their families and maternity staff.

2. Providing a safe and responsive antenatal and

postnatal care service
General guidance for services is provided in the Royal College of Obstetricians and
Gynaecologists (RCOG) and Royal College of Midwives (RCM) document Coronavirus
(COVID-19) infection in pregnancy.1

When planning services, maternity services should be cognisant of evidence that black, Asian
and minority ethnic group (BAME) individuals, women living in areas of multiple deprivation,
women with a higher BMI and those with pre-existing comorbidities are at particular risk of
developing severe and life-threatening COVID-19.2,3 Particular consideration should be given
to the experience of women of BAME background and women living with deprivation when
evaluating the potential or actual impact of any service change.

2.1 Provision of advice for women about antenatal and postnatal care

Maternity services should provide clear signposting for pregnant and postnatal women about
changes to antenatal and postnatal services and their reasoning on their trust or health board
websites through their social media accounts or through electronic notes.
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Such information should be co-produced and disseminated in partnership with Maternity
Voices Partnerships (MVPs) and Maternity Services Liaison Committees (MSLCs). It should
be available in community languages other than English, and in visual or easy to understand
formats as far as possible. Where such translation services are not available, consideration
should be given to providing local community online groups and radio stations with
information about any service changes, to enable them to share key information with the local
communities.

2.2 Providing in-person consultations safely

Where women require an in-person consultation because of the need for physical
examination and/or screening, a system should be in place for evaluating whether they have
symptoms that are suggestive of COVID-19, or if they meet current ‘stay at home’ guidance
(criteria for England, Wales and Northern Ireland and in Scotland). This may be a telephone
call prior to the appointment or an assessment at entry to the maternity setting, or both.

If a woman attends an antenatal appointment but describes COVID-19 symptoms, she should
be advised to return home immediately, unless she requires immediate emergency care. A
member of clinical staff should then make contact with the woman to risk assess whether an
urgent home antenatal appointment is required, whether the scheduled appointment can be
conducted remotely or if it can be delayed for a period of 10–14 days.

3. Key principles for the provision of antenatal

care through the evolving coronavirus (COVID-19)
pandemic
3.1 Maintaining essential monitoring

Many elements of antenatal care may require in person assessment, specifically blood pressure
and urine checks, measurement of fetal growth and blood tests. Some areas have implemented
the provision of home monitoring equipment to enable fewer in-person appointments in
some circumstances. Routine antenatal care is essential in detecting common complications of
pregnancy such as pre-eclampsia, gestational diabetes and asymptomatic urine infection.

The NICE Schedule of Antenatal Care4 should be maintained in its entirety. Women should
continue to receive the minimum of eight antenatal consultations, of these at least six contacts
should be in-person. Further detail is in section 4.1.

Current World Health Organization (WHO) guidance recommends a minimum of eight

antenatal contacts for low risk women.5 Evidence from lower and middle income countries
suggests that attendance at five in-person visits or less is associated with an increased risk of
perinatal mortality (RR 1.15; 95% CI 1.01–1.32, three trials).6

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A minimum of six in-person antenatal consultations is therefore advised. There is no
appropriate evidence to replace this minimum antenatal care with remote assessment.

3.1.1 Supporting the development of trusting relationships

As always, consideration should be given to enabling women and maternity staff to build
rapport and a trusting relationship during pregnancy when organising or modifying in-person
and virtual maternity care. This relationship encourages engagement in antenatal care and
enhances the ability of maternity staff to notice changes in the woman’s health, and to support
her to talk openly about concerns and problems.

In-person appointments should be prioritised for women at increased risk of complications

because of COVID-19, including women from BAME groups. This is likely to be most easily
facilitated by providing in-person appointments whenever possible and particularly at the
start of the pregnancy. Telephone and text communication can form one element of antenatal
contact, but they are unlikely to be as effective and lead to a relationship of trust without initial
in-person contact.

Video consultation can also be used to support more personal interaction, and should aid
the professional to understand the woman and her context more fully than telephone only
communication. However, when offering video consultation, midwives and obstetricians should
be aware of the limitations of the speed of data connections and costs involved in the use of
mobile data. Women should not be disadvantaged if they are unable to access adequate data
for video consultations. Further information about safely providing virtual consultations can be
found in the RCM briefing7 and the accompanying poster, and from the NHS in Scotland.

3.2 Building remote care support capacity

Maternity services should aim to maximise the use of remote means to provide additional
antenatal consultations. Remote consulting enables greater compliance, with social distancing
measures recommended for pregnant women and maternity staff, while enabling a pregnant
woman to have a partner, family member or friend join the appointment for support.

Remote appointments will be appropriate for a range of consultations, including:

• Some routine or specialist antenatal and postnatal appointments (see table in section
4.1.1).

• Consultations with the obstetric or anaesthetic team that do not require physical
examination or blood tests.

• Where additional support is required for women at risk of or currently experiencing

mental health problems.

• Maintaining contact with families living with a range of vulnerabilities or where there
are safeguarding concerns.
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• Discussion of plans for birth.

• Monitoring of the health and wellbeing of women and their babies, when women are
self-isolating because of COVID-19 symptoms or they/a household member have
received a positive COVID-19 test result.

• Provision of breastfeeding support, early parenting advice and guidance, and health
support after birth (such as pelvic floor exercises).

Maternity staff should be provided with the technology and training to be able to offer remote
antenatal and postnatal consultations. Consideration should be given to enabling staff who
are identified as vulnerable or currently self-isolating but well, to provide this remote support.
Some areas have created schemes to help address digital poverty, through the targeted
provision of IT hardware for those without so that they are able to access care through virtual
means.

3.3 Use of home appointments

Home visits may be preferable to attendance at a hospital, provided the woman and everyone
in their household is well.

Maternity staff attending homes should be mindful of exposure to COVID-19 in a home visit
and should adhere to strict infection control procedures when entering and leaving homes.
It has been shown that SARS-CoV-2 can survive on surfaces for several days.8 Maternity staff
should wear a face covering and be provided with appropriate personal protection equipment
(PPE) when caring for women with suspected infection or when entering homes where other
members of the household have symptoms. The RCM has provided guidance for staff 9 and
accompanying information for women on preparing for home visits.

3.4 Capacity

Maternity units will have differing capacity issues throughout the autumn and winter. A daily
discussion should be scheduled with senior team members with oversight of the antenatal
service, to review service provision and available staff. Where required, the appointments
highlighted in section 4.1.1 as being in-person appointments should be prioritised.

3.5 Staffing Numbers

Where there is acute staff absence, existing systems for recruiting additional staff should be
used. Maternity support workers, midwifery students, independent midwives and obstetric
team members can be used to support core service provision.

3.6 Antenatal education

Services, where they have not already done so, should seek to provide remote antenatal
education classes. As in-person classes are re-introduced, remote antenatal classes may be
maintained as they may be more accessible and acceptable for some women.
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4. Antenatal appointments modified schedules
4.1 Low risk women

Where continuity models of care are in place and these are able to continue, women should
receive care from their continuity team and primary midwife.

• Women should, where possible, be offered an in-person booking appointment or a

one-stop clinic appointment that includes booking and scan together.

o In general, women should have a minimum of six in-person antenatal contacts
in total.

• Wherever possible, scans and antenatal appointments and other investigations should
be provided within a single visit, involving as few staff as possible.

• If modifications to the pre-pandemic antenatal schedule are unavoidable, suggested

modifications to the existing schedule of antenatal care for low risk women, including
replacing in-person appointments with remote assessments are detailed in the table
below.

• At all remote appointments, women should be asked about their wellbeing and, if in
their third trimester, fetal movements. If a woman is concerned about fetal movements
or her wellbeing physical attendance should be advised at a designated site.

• Consider offering outpatient induction of labour for low risk women.10,11

4.1.1 Suggested modifications to NICE Schedule of Antenatal Care for low risk women

• The NICE Schedule of Antenatal Care should be maintained in its entirety. Women
should continue to receive the minimum of eight antenatal consultations, of these at
least six contacts should be in-person.

• Services should regularly review the ongoing impact of any changes to the schedule of
appointments, through local governance procedures.

• Where there is significant staff isolation or sickness, services will need to consider
reducing the provision of in-person appointments. The appointments shown below in
green should be maintained in-person.

• As early as possible when staffing allows, services should work towards reinstating all
appointments to return to pre-pandemic appointment schedules.

• In line with recommendations made in RCOG/RCM guidance Coronavirus

(COVID-19) infection in pregnancy, all women should be asked about their mental

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 wellbeing at every maternity appointment. Where a woman identifies that she is
experiencing psychological distress including high levels of anxiety or depression,
additional appropriate support should be instigated as rapidly as possible.

• Services should consider the needs of vulnerable women, including those who are
more likely to develop severe complications from COVID-19, when reorganising
services.

Visit Who What Modifications

1 Booking All women Full history, initial screening for medical,

visit psychological and social risk factors. Combine
appointments
1+ Dating All women Combined antenatal screening, all where possible
scan blood tests, blood pressure (BP) and
urine testing.
16 All women Review results of screening review,
weeks discuss and record the results of all Potential virtual
screening tests. appointment

Reassess planned pattern of care for

the pregnancy and identify women who
need additional care.

Give information about ongoing care.

2 18-20 All women Routine anomaly scan.

weeks
Check BP and urine at this visit.

25 Nulliparous Measure fundal height, BP and urine; Potential virtual

weeks women review scan results. appointment

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 3 28 weeks All women Discuss current health.
Enquire about fetal movements.

Discuss mental wellbeing, and offer

advice and sources of further support Maintain
and information. appointment.
Follow up any safeguarding concerns.
Discuss plans for antenatal classes
(remote access).

Measure fundal height, BP and test

urine; repeat blood tests to screen
for anaemia and red blood cell
alloantibodies; anti-D prophylaxis for
Rhesus negative women.

31 weeks Nulliparous Measure fundal height, BP and test Potential virtual

women urine. appointment
4 34 weeks All women Measure fundal height, BP and test Maintain in-person
urine; discuss results of investigations appointments. If
at 28 weeks; discuss birth choices. need to reschedule
Discuss wellbeing, fetal movements. because of self-
Follow up safeguarding issues isolation,
see or contact all
5 36 weeks All women Measure fundal height, BP and test women within 3
urine; discuss fetal movements and weeks of previous
wellbeing, discuss plans for birth and contact.
all usual care.
38 weeks All women Measure fundal height, BP and test
urine; discuss fetal movements and
wellbeing, discuss plans for birth and
all usual care.
6 40 weeks Nulliparous Measure fundal height, BP and test
women urine; give information about options
for prolonged pregnancy
Post All women Measure fundal height, BP and test Consider co-
dates who have urine; discuss fetal movements and scheduling
from not given wellbeing appointment with
41+0 12
birth offered outpatient
/ inpatient IOL to
(Locally avoid a further
agreed attendancea
protocol)

a
If, following informed discussion, a woman declines induction for prolonged pregnancy,
remote consultation with a senior obstetrician or consultant midwife should be offered to
discuss further steps.
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4.2 Women at increased risk of complications

Where continuity models of care are in place and these are able to continue, women should
receive care from their continuity team and primary midwife, in addition to specialist services.
Continuity of carer is likely to be of particular importance for women at higher risk of
complications from COVID-19, mental health problems, obstetric problems and living with
multiple deprivation.

Some women (as many as 50%) have a medical or obstetric condition or complication
that necessitates additional appointments or multidisciplinary care during pregnancy. Those
appointments that do not require measurement of fundal height, blood or urine tests, or scans,
may be provided remotely via video or teleconferencing.

BAME women have been identified as being at higher risk of developing severe illness if
they contract COVID-19. They should be advised of their higher risk of complications at the
start of their pregnancy, and the importance of avoiding contracting the virus through careful
infection control practices and social distancing. Women who are over 35 years, with a BMI
of over 30 kg/m2, or who have underlying medical conditions also have an elevated risk of
becoming unwell with COVID-19.

Services should ensure that these higher risk women who test positive for COVID-19 or
who describe symptoms, should be provided with appropriate follow-up care to monitor the
severity of their illness, which can be through regular remote contact.

4.2.1 Triaging obstetric antenatal clinics to streamline services and reduce duplication of
hospital or healthcare worker contacts

In order to rationalise appointments, obstetric antenatal referrals can be triaged locally by a

consultant, with a telephone appointment to discuss a proposed plan of care with the woman.
This means that, in general, women will follow their schedule of care with the midwives and
have care with obstetricians in a targeted way.

5. Postnatal care
Postnatal care should be individualised according to the woman and newborn’s needs and
should follow the NICE guidance for postnatal care as far as possible.13

• The minimum recommended number of contacts is three as per NICE

recommendations: at day 1 following birth (if at home) or discharge from maternity
unit (if admitted); day 5; and day 10. The visits on day 1 at home and day 5 (for the
newborn blood spot) should be prioritised as in-person appointments.

• Maternity services should offer a combination of in-person and remote postnatal

follow-up, according to the woman and baby’s needs. Prioritise in-person visiting for
women with:

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 o known psychosocial vulnerabilities,

o operative birth,

o premature/low birthweight baby,

o other medical or neonatal complexities.

• Where continuity models of care are in place and these are able to continue, women
should continue to receive care from their continuity team and primary midwife. Aim
to ensure continuity of midwife for remote postnatal care.

• Home visits may be preferable to community clinic visits to comply with social
distancing, but maternity staff safety must also be maintained.

• It may be necessary because of staff shortages to consider further amendments to

postnatal care:

o Provision of care by senior student midwives and maternity support workers.

o Reduction of in-person visits, particularly for healthy term multiparous women

and their babies.

• It is important to coordinate postnatal care with local health visitors to ensure smooth
transfer of care.

• Remote support by third sector organisations is invaluable to provide support for

breastfeeding, mental health and early parenting advice.

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 Authors
Mary Ross-Davie, RCM Director

Jaki Lambert, Midwifery Advisor, Scottish Government

Lia Brigante, RCM Quality and Standards Advisor

Clare Livingstone, RCM Policy advisor

Susanna Crowe, RCOG Each Baby Counts Learn and Support/Royal London
Hospital

Pran Pandya, PHE/UCLH

Eddie Morris, RCOG

Pat O’Brien, RCOG

Jennifer Jardine, RCOG Obstetric Fellow

Sophie Relph, RCOG Obstetric Fellow

Gemma Goodyear, RCOG Obstetric Fellow

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Summary of previous changes

Version Date Summary of changes

1.1 17.4.20 3.1: Clarification added that face-to-face contacts are in person, physical appointments.

1.1 17.4.20 3.2: Clarification added that remote appointments enable a partner or supporter to
join the appointment.
1.1 17.4.20 3.5: Clarified that independent midwives may be used to support service delivery.
1.1 17.4.20 4.1.1: Highlighted recommendation from RCOG/RCM coronavirus guidance to ask
about mental wellbeing at each appointment.
1.1 17.4.20 4.1.1: Modification to post-dates appointment to clarify that women should be offered
immediate induction of labour if practical and acceptable.

1.1 17.4.20 5: Highlighted recommendation from RCOG/RCM coronavirus guidance to offer face-
to-face and remote postnatal follow-up.

1.2 24.4.20 Appendix - Patient information: Removed Appendix, will be published separately in due
course.
2 22.5.20 2: Statement added: ‘When reorganising services, maternity services should be
particularly cognisant of emerging evidence that black, Asian and minority ethnic group
(BAME) individuals are at particular risk of developing severe and life-threatening
COVID-19. There is already extensive evidence on the inequality of experience
and outcomes for BAME women during pregnancy and birth in the UK. Particular
consideration should be given to the experience of women of BAME background and
women living with multiple deprivation when evaluating the potential or actual impact of
any service change.’
2 22.5.20 2.1: Statement added: ‘Such information should be available in community languages
other than English and in visual or easy-to-understand formats as far as possible. Where
such translation services are not available, consideration should be given to providing
local community online groups and radio stations with information about any service
changes, to enable them to share key information with the local communities about
service change.’
2 22.5.20 3.1: Inserted statement: ‘Some areas are implementing the provision of home
monitoring equipment which may enable fewer face-to-face appointments in some
circumstances.’
2 22.5.20 3.1.1: Additional section added: ‘Supporting the development of trusting relationships’.

2 22.5.20 3.2: Added note that remote appointments may be particularly suitable for women with
suspected or confirmed COVID-19.
2 22.5.20 3.3: Statement added: ‘The RCM has provided guidance for staff and women in
preparing for home visits.’

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2 22.5.20 4.1.1: Recommendations added:

• Where services can support it, the NICE Schedule of Antenatal Care should be
maintained in its entirety.

• Services should review the ongoing impact of any changes to the schedule of
appointments, through local governance procedures.

• As early as possible when staffing allows, services should work towards
reinstating all appointments to return to pre-pandemic appointment schedules.

• Services should consider the needs of vulnerable women, including those

who are more likely to develop severe complications from COVID-19, when
reorganising services.

2 22.5.20 4.1.1: Small edits made to associated table to emphasise that ‘amber’ appointments
should be maintained if staffing allows or additional concerns.
2 22.5.20 4.2: Added further recommendations about continuity of carer and care for women
at increased risk of severe illness if they contract COVID-19, including BAME women,
women who are overweight or obese and those with underlying medical conditions.
2 22.5.20 5: Clarification added that the minimum recommended number of postnatal contacts is
three: at day 1 following birth (if at home) or discharge from maternity unit (if admitted),
day 5 and day 10.
2.1 19.6.20 5.1: Clarification added that the first visit after birth should be prioritised as a face-to-
face visit.
2.2 10.7.20 0: Added a note on the implementation of this guidance to clarify that the guidance
was intended for the peak of the pandemic and that services should return to normal
practice as soon as the local risk of transmission and prevalence allows.

15
References
1. Royal College of Obstetricians and Gynaecologists/Royal College of Midwives. Coronavirus
(COVID-19) infection and pregnancy [https://www.rcog.org.uk/en/guidelines-research-services/
guidelines/coronavirus-pregnancy/]. Accessed 08 October 2020.

2. Allotey J, Stallings E, Bonet M, Yap M, Chatterjee S, Kew T, et al. Clinical manifestations, risk
factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living
systematic review and meta-analysis. BMJ 2020;370:m3320.

3. Knight M, Bunch K, Vousden N, Morris E, Simpson N, Gale G, et al. Characteristics and

outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in
UK: national population based cohort study. BMJ 2020;369:m2107.

4. National Institute of Health and Care Excellence. Antenatal care for uncomplicated
pregnancies. NICE Clinical Guideline 62; 2008.

5. World Health Organization. WHO recommendation on antenatal care contact schedules.

2016 [Updated 2018] [https://extranet.who.int/rhl/topics/improving-health-system-
performance/who-recommendation-antenatal-care-contact-schedules]. Accessed 08 October
2020.

6. Dowswell T, Carroli G, Duley L, Gates S, Gülmezoglu AM, Khan-Neelofur D, et al. Alternative

versus standard packages of antenatal care for low-risk pregnancy. Cochrane Database Syst
Rev 2015;(7):CD000934.

7. Royal College of Midwives [https://www.rcm.org.uk/media/4192/virtual-consultations-v20-

24-july-2020-review-24-august-2020-1.pdf]. Accessed 08 October 2020.

8. US Centers for Disease Control. Public Health Responses to COVID-19 Outbreaks on

Cruise Ships — Worldwide, February–March 2020. 2020;69:347–52.

9. Royal College of Midwives. Guidance for midwives, student midwives and maternity support
workers providing community-based care during the Covid-19 pandemic [https://www.rcm.
org.uk/media/3900/home-visit-guidance-for-midwives.pdf]. Accessed 08 October 2020.

10. National Institute of Health and Care Excellence. Inducing Labour. NICE Quality Standard
60; 2014.

11. Royal College of Midwives Midwifery Blue-Top Clinical Guidance 2: Midwifery Care for
Induction of Labour. London: RCM; 2019.

12. National Institute of Health and Care Excellence. Inducing Labour. NICE Clinical Guideline
70; 2008.

13. National Institute of Health and Care Excellence. Postnatal care up to 8 weeks after birth.
NICE Clinical Guideline 37; 2015.
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DISCLAIMER: The Royal College of Obstetricians and Gynaecologists (RCOG) has produced this
guidance as an aid to good clinical practice and clinical decision-making. This guidance is based on
the best evidence available at the time of writing, and the guidance will be kept under regular review
as new evidence emerges. This guidance is not intended to replace clinical diagnostics, procedures
or treatment plans made by a clinician or other healthcare professional and RCOG accepts no
liability for the use of its guidance in a clinical setting. Please be aware that the evidence base for
COVID-19 and its impact on pregnancy and related healthcare services is developing rapidly and the
latest data or best practice may not yet be incorporated into the current version of this document.
RCOG recommends that any departures from local clinical protocols or guidelines should be fully
documented in the patient’s case notes at the time the relevant decision is taken.

@RCObsGyn @rcobsgyn @RCObsGyn

Royal College of Obstetricians and Gynaecologists, 10-18 Union Street, London, SE1 1SZ
T: +44 (0) 20 7772 6200 E: [email protected] W: rcog.org.uk Registered Charity No. 213280

17