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Woman in labour

   Management of Labour   


Labour has three stages: The first stage is when the neck of the womb opens to 10cm dilated. The second stage is when the baby moves down through the vagina and is born. The third stage is when the placenta (afterbirth) is delivered. Labour and birth are intense and personal experiences.  Pregnancy can be a time of great anticipation and excitement but parents-to-be often have lots of questions about ‘the big day’ when labour starts and the baby will finally arrive. It is important that midwives and parents discuss the aspects of labour that will need decisions, both as part of a birth plan and as labour progresses. This will include discussing the options involved in labour and delivery and understanding the situations in which it might be necessary to take a course of action that isn’t in the woman’s birth plan.

This Highlight presents recent research evidence on some aspects of the management of labour, including:

  • the induction of labour
  • waterbirth
  • interpretation of the fetal heart rate
  • pain management
  • position during the second stage of labour with or without an epidural

It provides information and context to the essential decisions for a mother-to-be and her midwife and care-givers. The evidence from these studies will be useful for all women – there is no particular focus on high-risk pregnancies. All the evidence we have included should be considered within the context of a woman’s medical and pregnancy history. 

Published: March 2019

Pregnant women being induced

The induction of labour

This section looks at a number of studies focusing on the outcomes of women being induced.




 Evidence from a review comparing the outcomes for the women and their babies of immersion in water during labour.

Fetal Heart Rate Monitoring

Interpretation of the fetal heart rate

Fetal monitoring in labour wards, comparing computer software with not using this support. 

Epidural Injection

Pain management

A look at studies involving first-time mothers using different methods of pain relief

Woman in labour

Labour position with or without epidural

An analysis of studies comparing birth positions of labour for first-time mothers.

Evidence at a glance

Evidence at a glance

Headline features from the studies in this highlight.

Researchers around a table

An in-depth look at the research

This highlight is based upon the following published studies.

Questions for Parents to be


Questions to consider for pregnant women and their birthing partner and for midwives 

live births in the UK in 2017
of all labours were induced in 2017-2018 in England
Freestanding midwifery units in England

Related Blog Posts

Annie's Labour Story

Interview with mother of two young children, Annie, about the management of labour Highlight. Annie lives in Sheffield. She has two children, a two year old son and a daughter aged five months.

Emma on Management of Labour

Emma had her first baby eight months ago, she talks about how useful she thinks our Highlight: Management of Labour will be to expectant mothers.



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