The Association of Ontario Midwives

The Association of Ontario Midwives

Clinical Guidelines

Clinical practice guidelines (CPGs) are documents that describe research evidence relevant to a given clinical topic. The AOM's CPGs are evidence-based tools consistent with the midwifery philosophy of care. These CPGs are created for midwives and other health care providers to use in clinical decision-making, but women receiving midwifery care may also find them to be a valuable resource. More guidelines and more information about CPG development processes are available on the AOM website.

Choice of Birthplace - Guideline for discussing choice of birthplace with clients

Choice of Birthplace - Guideline for discussing choice of birthplace with clients

This document is to provide guidance for midwives when facilitating informed choice discussions with clients on choosing birthplace and it is not intended to dictate a course of action. Inspired by the recommendations on place of birth in the National Institute for Healthcare Excellence (NICE) guidance on intrapartum care, this guideline provides a review of best available evidence relevant to the health-care system in Ontario, Canada.

Postpartum Hemorrhage (CPG #17, 2016)

Postpartum Hemorrhage (CPG #17, 2016)

This CPG provides a critical review of the research literature on the prevention and management of postpartum hemorrhage (PPH). (Disponible en français sur demande.)

 

 

Evidence relating to the following will be discussed:

  • Definition, incidence and causes
  • Risk factors
  • Prevention
  • Treatment
  • Recovery
  • Client experiences

Supplementary info includes: PPH CPG Summary and PPH Grade Tables.



Additional resources on PPH include: a client resource on recovering from PPH; a video featuring two client experiences of PPH; and a resource for midwives on client experiences of PPH.

Group B Streptococcus: Postpartum Management of the Neonate (CPG #16, 2014)

Group B Streptococcus: Postpartum Management of the Neonate (CPG #16, 2014)

This CPG provides a critical review of the research literature on the management of Group B streptococcus (GBS) during the neonatal period. This CPG is meant to complement and be used in conjunction with AOM CPG No. 11 – Group B Streptococcus: Prevention and Management in Labour (2010). Evidence relating to the following will be discussed:

  • Early-onset Group B streptococcal disease (EOGBSD) occurring in the first 7 days of life.
  • Intrapartum risk factors for EOGBSD and management decisions for the newborn.
  • Effectiveness and duration of intrapartum antibiotic prophylaxis (IAP).
  • Neonatal management: assessment and monitoring for EOGBSD.

The AOM has also produced a resource for midwifery clients titled Normal Newborn Behaviour that explains Group B streptococcal disease and symptoms that could indicate other illnesses. 

Hypertensive Disorders of Pregnancy (CPG #15, 2012)

Hypertensive Disorders of Pregnancy (CPG #15, 2012)

This CPG provides a critical review of the research literature on the screening, diagnosis and management of hypertensive disorders of pregnancy (HDP) within the context of provision of midwifery care in Ontario. Evidence relating to the following is discussed:

  • Risk factors for HDP
  • Prevention strategies for HDP
  • Screening, diagnosis, assessment and monitoring of HDP
  • Management of HDP in antenatal, intrapartum and postpartum care

The AOM has also produced a resource titled What are Hypertensive Disorders of Pregnancy? for midwifery clients that explains HDP in plain language.

Management of Prelabour Rupture of Membranes at Term (CPG #13, 2010)

Management of Prelabour Rupture of Membranes at Term (CPG #13, 2010)

This CPG provides a critical review of the research literature on the management of prelabour rupture of membranes (PROM) at term gestation. Evidence relating to the following is discussed:

  • Impact of PROM on maternal and neonatal outcomes
  • Diagnosis and assessment of PROM
  • Management options for PROM
The Management of Women with a High or Low Body Mass Index (CPG #12, 2010)

The Management of Women with a High or Low Body Mass Index (CPG #12, 2010)

This CPG provides a critical review of the research literature on the management of uncomplicated pregnancy in women who have a pre-pregnancy body mass index (BMI) less than 18.5 or greater than or equal to 30. Topics of interest:

  • Risk Factors
  • Prevention of Poor Outcomes
  • Associated Complications (Pregnancy, Intrapartum, Postpartum Maternal, Neonatal/Infant)
Group B Streptococcus: Prevention and Management in Labour (CPG #11, 2010)

Group B Streptococcus: Prevention and Management in Labour (CPG #11, 2010)

The objective of this CPG is to provide a critical review of the research literature on the management of Group B Streptococcus (GBS) during labour. Evidence relating to the following is discussed:

  • The prevention of Early-onset Group B Streptococcal Disease (EOGBSD)
  • Prenatal screening
  • Management during the antenatal and intrapartum period
Management of the Uncomplicated Pregnancy Beyond 41+0 Weeks’ Gestation (CPG #10, 2010)

Management of the Uncomplicated Pregnancy Beyond 41+0 Weeks’ Gestation (CPG #10, 2010)

This CPG provides a critical review of the research literature for women reaching 41+0 weeks’ gestation and beyond in an uncomplicated pregnancy, as well as to provide recommendations regarding management options. Evidence relating to the following is discussed:

  • Factors contributing to an increased risk of postdates pregnancy
  • Effective interventions for reducing the rate of postdates pregnancy
  • Impact of postdates pregnancy on maternal and neonatal outcomes
  • Management options for postdates pregnancy.

The AOM has produced a resource for midwifery clients titled When Your Pregnancy Goes Past Your Due Date, which explains the risks and recommendations for an uncomplicated pregnancy that goes past 40 weeks.