Intrapartum Care

 Induction of labour 

We analyse decisions and monitoring related to the induction process, including elements relating to consent, delays, escalation and timings. We can review related CTGs and other documentation to provide opinion on breach of duty.

 Use of cardiotocography (CTG) and fetal monitoring

Our experts interpret both intermittent and continuous fetal monitoring, assessing whether CTG traces were interpreted and acted upon accurately, and whether any delays contributed to adverse outcomes.

 Home birth

We review antenatal and intrapartum risk assessments for planned home births and evaluate the timeliness and appropriateness of any transfers to hospital care. We can review care for both planned and unplanned home births. We can review care of the neonate born at home also.

 Water birth

We examine the planning and management of water births, including recognition of risks and intervention thresholds.

 Care in the first stage of labour

Our reports address all elements of midwifery care in labour including progression monitoring, pain management, and the response to complications during the latent and active phases.

 Care in the second stage of labour

We consider all elements of midwifery care in the second stage of labour including care provided during pushing, fetal heart monitoring, escalation, and recognition of prolonged second stage and any maternal or fetal concerns.

 Management of shoulder dystocia

We assess whether shoulder dystocia was recognised promptly and managed according to best practice, minimising risk to mother and baby. We can also assess whether appropriate risk assessing for this obstetric emergency occurred antenatally and during labour.

 Delay in recognising or responding to fetal heart rate abnormalities and signs of hypoxia

Our expert midwives look closely at risk assessments, CTG management, intermittent auscultation, escalation plans, and timing of escalations when fetal compromise was suspected or recognised.

 Vaginal birth after caesarean (VBAC)

We offer insight into midwifery care involving risk assessment, birth planning and escalation in cases involving VBAC to ensure guidance was followed.

 Third stage of labour management (placenta delivery, retained products)

We analyse management of delivery of the placenta, including safe delivery and responding to complications such as retained products and abnormal bleeding and incomplete placentas and membranes.

 Maternal collapse and obstetric emergencies

We provide authoritative review of midwifery responses to time-sensitive obstetric emergencies, including recognition, adherence to protocols, speed of action, and escalation.