NICE Intrapartum care for healthy women and babies (update) 2023 - AIMS Comments

AIMS submitted comments on the draft NICE Guideline update on Intrapartum care for healthy women and babies in May 2023. You can read our comments here

The updated guidelines were published on the 29th September 2023 and can be found here

AIMS submitted 32 stakeholder comments and we are pleased to see that the majority of our suggestions were accepted in whole or in part by the Guideline Development Group. You can read our comments and those of other stakeholders, and the responses to them here.

We are particularly pleased to see the strengthening of the language around autonomy, including the recommendation:

“All staff and organisations should ensure that all birth settings have a culture of respect for each woman as an individual undergoing a significant and emotionally intense life experience, so that the woman is in control, is listened to, her choices are supported, and she is cared for with compassion.”

We are also pleased to see that the comment in the previous version that a BMI at booking of 30 to 35 kg/m2 was a factor “indicating individual assessment when planning place of birth” has been reworded to put the emphasis on the woman’s decision-making:

“Advise women that, in general, the higher their body mass index (BMI) at booking (and particularly with a BMI above 35 kg/m2), the greater the likelihood of complications, so this may be something they wish to think about when planning their place of birth.”

In response to our suggestion they have added the clarification that “in general the risks of complications are higher for nulliparous women with an increased BMI compared with multiparous women with an increased BMI.” They also “amended the summary tables in the guideline to include evidence for multiparous and nulliparous women planning birth in an alongside midwifery unit to demonstrate that the risks are increased for nulliparous women but not for multiparous women, as you suggest.” However, we are disappointed that they failed to include the main point of our comment - that evidence (and, indeed, the figures in Appendix B of the guideline) suggests that the chances of a poor outcome for multiparous women with a BMI over 35 kg/m2 appear to be lower than for nulliparous women with a BMI in what is considered the ‘healthy’ rage of 18.5 to 24.9 35 kg/m2.

We plan to publish an article summarising the updates and our comments on these in the December issue of the AIMS Journal.

All NHS Trusts/Boards should be reviewing their own local guidelines in the light of these updates. If you are an MNVP/MSLC user representative please ask them when and how they plan to do this, if not, then ask a local representative to check for you.


We hope that this page is of interest, especially to our colleagues in the maternity services improvement community.

The AIMS Campaigns Team relies on Volunteers to carry out its work. If you would like to collaborate with us, are looking for further information about our work, or would like to join our team, please email campaigns@aims.org.uk.

Please consider supporting us by becoming an AIMS member or making a donation. We are a small charity that accepts no commercial sponsorship, in order to preserve our reputation for providing impartial, evidence-based information. You can make donations at Peoples Fundraising. To become an AIMS member or join our mailing list see Join AIMS

AIMS supports all maternity service users to navigate the system as it exists, and campaigns for a system which truly meets the needs of all.

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