ABSTRACT
It is important to get the diagnosis of labour right since this is the fundamental decision on which all subsequent management is based. Unwarranted interventions in the latent phase of labour, particularly amniotomy, could convert an otherwise normal labour to an abnormal one. If the woman is in established labour, then her progress and wellbeing should be assessed and managed by her named midwife, who will be aware at all times of the patient’s wishes. The continuous presence of a midwife or other support person (partner, friend or family) reduces the likelihood of operative delivery or low Apgar score. It is also associated with a shorter duration of labour and reduced requirement for analgesia. Adoption of the upright position during labour facilitates efficient uterine contractions, shortens the latent phase and reduces the need for analgesia. A woman in labour needs energy and should not be starved unless she is likely to require a general anaesthetic.
