| For women in labour (P), does a policy that promotes respectful, dignified, women-centred maternity practice (I), compared with usual practice (C), improve birth outcomes (O)? | Maternal birth experience
Mode of birth
Duration of labour
Use of pain relief methods
Perineal/vaginal trauma
Perinatal hypoxia-ischaemia |
| For women in labour (P), does effective communication by health care staff (I), compared with usual practice (C), improve birth outcomes (O)? | Maternal birth experience
Mode of birth
Duration of labour
Use of pain relief methods
Perineal/vaginal trauma
Perinatal hypoxia-ischaemia |
| For women in labour (P), does continuous labour support and companionship (I), compared with usual practice (C), improve birth outcomes (O)? Is the use of a particular type of provider of continuous support (e.g. a doula, family member or hospital staff) more effective and safer than another, for improving birth outcomes (O)? | Mode of birth
Perineal/vaginal trauma
Duration of labour
Augmentation of labour
Use of pain relief
Maternal birth experience
Perinatal hypoxia-ischaemia
Long-term infant outcomes |
| What are the appropriate definitions of first (latent and active phases) and second stages of spontaneous labour that are associated with good birth outcomes? | Duration of latent phase
Duration of active phase
Duration of first stage
Definition of onset of latent phase
Definition of onset of active phase
Duration of second stage |
| Should a cervical dilatation rate threshold of 1 cm per hour (as depicted by the partograph alert line) be used to identify women at risk of adverse birth outcomes among healthy pregnant women with a spontaneous labour onset? | True positive (TP)
True negative (TN)
False positive (FP)
False negative (FN)
Sensitivity
Specificity |
| For pregnant women without risk factors at the onset of spontaneous labour, what are the cervical dilatation patterns associated with normal birth outcomes? | Time for cervical dilatation to advance by 1 cm from one level of cervical dilatation to the next
Rate of change from one level of cervical dilatation to the next |
| For healthy pregnant women presenting in spontaneous labour at term (P), does a policy of delayed labour ward admission until active phase (I), compared with a policy of direct labour ward admission (C), improve birth outcomes (O)? | Mode of birth
Duration of labour
Augmentation of labour
Use of pain relief
Maternal morbidity
Maternal birth experience
Perinatal hypoxia-ischaemia
Perinatal/neonatal death
Born before arrival at facility |
| For healthy pregnant women presenting in labour (P), does clinical pelvimetry routinely performed on admission (I), compared with no clinical pelvimetry (C), improve birth outcomes (O)? | Mode of birth
Maternal morbidity
Perineal/vaginal trauma
Maternal birth experience
Birth trauma
Perinatal hypoxia-ischaemia
Perinatal/neonatal death |
| For healthy pregnant women presenting in spontaneous labour (P), does routine cardiotocography for assessment of fetal status on labour admission (I), compared with intermittent auscultation (C), improve birth outcomes (O)? | Mode of birth
Maternal birth experience
Fetal distress
Perinatal hypoxia-ischaemia
Perinatal/neonatal death
Long-term infant outcomes |
| For healthy pregnant women in labour (P), does continuous cardiotocography for assessment of fetal status (I), compared with intermittent auscultation (C), improve birth outcomes (O)? | Mode of birth
Use of pain relief
Maternal birth experience
Fetal distress
Perinatal hypoxia-ischaemia
Perinatal/neonatal death
Long-term infant outcomes |
| For healthy pregnant women in labour (P), is the use of a particular method of intermittent auscultation for monitoring of fetal heart rate (I), compared with other methods intermittent auscultation (C), more effective and safe for improving birth outcomes (O)? | Mode of birth
Maternal birth experience
Fetal distress
Perinatal hypoxia-ischaemia
Perinatal/neonatal death
Long-term infant outcomes |
| For healthy pregnant women requesting pain relief during labour (P), should epidural analgesia (I), compared with no pain relief or other forms of pain relief (C), be offered to relieve labour pain and improve birth outcomes (O)? | Mode of birth
Pain relief
Maternal birth experience
Augmentation of labour
Duration of labour
Adverse effects
Perinatal hypoxia-ischaemia
Long-term infant outcomes |
| For healthy pregnant women requesting for pain relief during labour (P), should relaxation techniques for pain management (I), compared with no pain relief or other forms of pain relief (C), be offered to relieve labour pain and improve birth outcomes (O)? | Mode of birth
Pain relief
Maternal birth experience
Augmentation of labour
Duration of labour
Adverse effects
Perinatal hypoxia-ischaemia
Long-term infant outcomes |
For healthy pregnant women requesting pain relief during labour (P), should parenteral opioid(s) (I), compared with no pain relief or other forms of pain relief (C), be administered to relieve labour pain and improve birth outcomes (O)?
If so, which parenteral opioid(s) should be offered to eligible women? | Mode of birth
Pain relief
Maternal birth experience
Augmentation of labour
Duration of labour
Adverse effects
Perinatal hypoxia-ischaemia
Long-term infant outcomes |
| For healthy pregnant women requesting pain relief during labour (P), should massage and other manual techniques for pain management (I), compared with no pain relief or other forms of pain relief (C), be offered to relieve labour pain and improve birth outcomes (O)? | Mode of birth
Pain relief
Maternal birth experience
Augmentation of labour
Duration of labour
Adverse effects
Perinatal hypoxia-ischaemia
Long-term infant outcomes |
| For women without epidural analgesia in the second stage of labour (P), does the adoption of an upright birthing position (e.g. sitting, standing or squatting) (I), compared with a recumbent position (C), improve birth outcomes (O)? | Duration of labour
Mode of birth
Pain relief/intensity
Perineal/vaginal trauma
Maternal birth experience
Fetal distress
Perinatal hypoxia-ischaemia
Perinatal/neonatal death |
| For women with epidural analgesia in the second stage of labour (P), does the adoption of an upright birthing position (e.g. sitting, standing or squatting) (I), compared with a recumbent position (C), improve birth outcomes (O)? | Duration of labour
Mode of birth
Pain relief/intensity
Perineal/vaginal trauma
Maternal birth experience
Fetal distress
Perinatal hypoxia-ischaemia
Perinatal/neonatal death |
| For women in the second stage of labour (P), does spontaneous pushing (I), compared with directed pushing (e.g. with Valsalva/closed glottis) (C), improve birth outcomes (O)? | Duration of labour
Mode of birth
Perineal/vaginal trauma
Long-term maternal morbidity
Maternal birth experience
Fetal distress
Perinatal hypoxia-ischaemia
Perinatal/neonatal death |
| For women with epidural analgesia in the second stage of labour (P), does delayed pushing (I), compared with immediate pushing after full cervical dilatation (C), improve birth outcomes (O)? | Duration of labour
Mode of birth
Perineal/vaginal trauma
Long-term maternal morbidity
Maternal birth experience
Fetal distress
Perinatal hypoxia-ischaemia
Perinatal/neonatal death |
| For women in the second stage of labour (P), does any perineal technique (e.g. massage, warm compress or guiding) used for preventing perineal trauma (I), compared with no perineal technique or usual practice (C), improve birth outcomes (O)? | Perineal/vaginal trauma
Long-term maternal morbidity
Maternal birth experience
Birth trauma
Perinatal hypoxia-ischaemia |
| For women in the second stage of labour (P), does a policy of selective/restrictive use of episiotomy (I), compared with a policy of routine or liberal use of episiotomy (C), improve birth outcomes (O)? | Duration of labour
Maternal morbidity
Long-term maternal morbidity
Perineal/vaginal trauma
Use of pain relief
Maternal birth experience
Birth trauma
Perinatal hypoxia-ischaemia |
| For women in the second stage of labour (P), does the application of fundal pressure (I), compared to no fundal pressure (C), improve birth outcomes (O)? | Mode of birth
Duration of labour
Maternal mortality
Serious maternal morbidity
Perineal/vaginal trauma
Maternal birth experience
Birth trauma
Perinatal hypoxia-ischaemia
Perinatal/neonatal death |
