Midwives urged to smile at patients

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They range from greeting expectant mothers with a smile and knocking on doors before entering a room, to offering birthing pools as a means of pain relief.

New guidance from the National Institute for Health and Clinical Excellence (Nice) has highlighted the importance of good communication with women in labour and treating them with respect.

Clinical intervention should not be offered or advised where labour is progressing normally and the woman and baby are well, the guidelines state, and once a woman is in established labour she should receive supportive one-to-one care.

The guidance is expected to mean longer labours for some women but could also mean fewer medical interventions which can result in more painful and complicated labours. Currently around 600,000 women give birth in England and Wales every year.

Experts have said using water as pain relief during labour is more effective than any other pain relief barring the use of an epidural and can improve the experience of birth for women.

Dr Julia Sanders, a consultant midwife, and a member of the group which drew up the guidance said: "There is a perception that water is just nice. But it is the most effective form of pain relief barring an epidural in labour.

"I would like to see more women using water and fewer women using the types of pain relief that are less effective."

She added that the guidelines highlighted "very strongly" that communication with women in labour was "absolutely crucial".

Maureen Treadwell, of the Birth Trauma Association, said better levels of information and communication with women in labour would leave them less vulnerable to feeling "victims of events".