Sara Wickham explains the 2026 green-top guideline on shoulder dystocia. What’s new, and how to make the decisions that are right for you.
Shoulder Dystocia: new guidelines, your decisions
Physiological third stage: what is the evidence?
Dr Sara Wickham looks at the evidence for physiological third stage; an important physiological process and a key part of birth.
Cervical dilation is (now mathematically shown to be) unpredictable
Research has confirmed that, in spontaneous, naturally progressing labour, the rate of cervical dilatation is largely unpredictable.
Screening and the consequences of knowledge
Is it always good to know things, just because we can? Sara Wickham explores the consequences of knowledge.
Ten ways I can help midwifery students
Sara Wickham offers a variety of resources for student midwives and others studying birth-related areas.
What is cervical recoil?
What is cervical recoil, and why is it important? Sara Wickham explains why it can be normal for cervical dilation to go backwards in labour.
Announcing … Midwifery Wisdom!
Dr Sara Wickham’s latest book, Midwifery Wisdom, is now available! What midwives know, and why their knowledge matters more than ever.
When I am an old midwife…
Post-term pregnancy and induction of labour resources
This page lists all the resources available from Dr Sara Wickham on the topics of post-term pregnancy and induction of labour.
Weight-inclusive maternity care
Dr Sara Wickham looks at weight-inclusive maternity care. What is it, and what can research tell us about how it looks in practice?
Ten things you can do before clamping the umbilical cord…
Dr Sara Wickham suggests things that can be done before clamping the umbilical cord, thus ensuring that babies get their full complement of blood.
Five things parents should know if they decide to decline vitamin K
What information should we offer when parents decide to decline vitamin K? Sara Wickham offers an overview and an infographic.
Epidural Fever
Sara Wickham looks at the research relating to epidural fever, or LEAF, which has implications for women and babies.
Late pregnancy ultrasound: what’s the evidence?
Late pregnancy ultrasound is being offered to more and more women. Also known as third trimester ultrasound, this type of scan is offered to check things such as fetal growth, find out the baby’s presentation or position, assess amniotic fluid…
What is the BRAN or BRAIN analysis?
Sara Wickham defines the BRAN analysis, offering a bit of history and an explanation of what this decision making acronym means.
Induction increases the chance of caesarean
Over the years, I have shared a number of studies showing that induction increases the chance of caesarean. This is also something that I explain in depth in my book, In Your Own Time. It’s important that we discuss this…
Untangling tocophobia
‘What is it called,’ a woman asked, ‘when you’re fearful of medicalisation?’ Sara Wickham attempts to provide an answer to this.
GBS screening: the evidence
Dr Sara Wickham looks at studies exploring the evidence for GBS screening and treatment.
In Your Own Time: now available as an audiobook!
I’m really pleased to share that the audiobook version of In Your Own Time is now available. In Your Own Time is the most popular of my recent books. It explores how Western medicine has come to control the timing of labour, and why…
Whatever happened to the precautionary principle?
Ethically, medical intervention has to prove itself against nature. Not the other way around. Sara Wickham on induction and the precautionary principle.
The knee-jerk effect in maternity care
Sara Wickham looks at the knee-jerk effect in maternity care. When one or two adverse outcomes lead to sweeping policy changes, often with no evidence.
Vitamin K: evidence, risk and informed choice
Dr Sara Wickham looks at a paper on vitamin K which generated media coverage, and considers the evidence, and the wider issues.
What’s the evidence for raspberry leaf tea?
What’s the evidence for raspberry leaf tea in pregnancy? Dr Sara Wickham investigates, explaining what we do and don’t know.
Optimal cord clamping: what’s the evidence?
What do women want when it comes to the induction decision? Dr Sara Wickham investigates research which shows that it’s more complex than we might think.
Induction for advanced maternal age
Sara Wickham looks at recommendations made for induction of labour in older women, citing the lack of good evidence to support this.
Short-termism, induction, and adverse outcomes
One of the key criticisms of the technocratic approach to birth is that it focuses on short-term, physical outcomes while ignoring medium- and long-term consequences, and the wider mental and social implications of interventions. In this blog post, I’m going…
Let there be mood lighting…
Tips and tools for setting the right kind of lighting for labour and birth, both at home and in hospital, from Sara Wickham.
How language can obscure choice
Sara Wickham discusses how language can be used to obscure choice, or as a tool to exercise power, often in subtle ways that aren’t easily spotted.
Transvaginal examination – the need for care
Dr Sara Wickham looks at some of the information women need in order to make an informed decision about transvaginal ultrasound examination.
The benefits of water for birth
What are the benefits of water for birth? Sara Wickham looks at studies highlighting the advantages of this for women and babies.
Five questions to ask if you’re offered induction of labour
What are the best questions to ask if you’re offered induction of labour? This is something I get asked a lot. So I have put together this guide to the five best questions that you can ask in order to…
Fixed point due dates and wider windows
If Doctor Who (pick your favourite) turned up in front of you right now and offered you the chance to go elsewhere in time to change, remove, or amend one tenet of modern maternity care, what would you choose? Even…
Can Anti-D (RhoGAM) be made from unvaccinated blood?
Can Anti-D (RhoGAM) be made from unvaccinated blood? Dr Sara Wickham, author of Anti-D Explained, answers this question.
Induction of labour: what do women think?
Women want more information and support with decision making about induction of labour, especially when there’s no good medical reason for it
Birth in the media: what’s the problem?
Dr Sara Wickham looks at the representation of birth in the media and explains why we shouldn’t believe everything we read.
Paracetamol in pregnancy and birth
Sara Wickham looks at the use of paracetamol in pregnancy and birth, linking to trusted, evidence-based information on this.
The value of the knitting midwife
Sara Wickham tells the story of the Silent Knitting Workshop in Hawaii and reflects on the value of ‘the knitting midwife’.
Happy Holidays!
Happy Holidays from Sara Wickham. Here’s wishing you a fabulous festive season, and we’ll see you next year!
Three things I wish every woman knew about pregnancy and birth knowledge
Sara Wickham shares her thoughts on birth knowledge, women’s wisdom and what she wishes she could tell everyone about these topics…
Gestational diabetes
Dr Sara Wickham looks at research into gestational diabetes. This affects many women, but it’s not clear that current diagnosis and treatment is beneficial.
The ARRIVE Trial
Sara Wickham explains the ARRIVE Trial, and why the results aren’t as helpful or trustworthy as some people might tell you.
Which first-time mums are more at risk of caesarean?
Which first-time mums are more at risk of caesarean? There is growing concern about the number of unnecessary caesareans, and the rate of these is especially high in first-time mums. That concern has led researchers looking specifically at this question,…
Skin-to-skin should be standard care
Immediate skin-to-skin contact between new born babies and their mums brings many health benefits. Dr Sara Wickham explains the evidence, and a new Cochrane review whose authors suggest that withholding this may be unethical.
When is consent not consent?
Sara Wickham highlights the problem of asking people to make a decision about additional intervention during an intimate examination.
Does antenatal Anti-D help the current baby?
Does antenatal anti-D help the current baby? Sara Wickham demystifies the science and answers this question in simple terms.
The trouble with birth and maternity guidelines…
Sara Wickham discusses research showing that only 9-12% of RCOG Green-Top guidelines are based on best quality evidence.
Academic Tips
Our latest information hub gathers together classic articles and blog posts written for and about midwives and midwifery practice by Dr Sara Wickham.
Seven reasons to question restrictions on birth pools for women with a higher BMI
Many women with a higher BMI are told about restrictions on birth pools, and that they cannot use a birth pool during labour or birth. But is this restriction really about safety? Is it evidence-based? Or is it rooted in…
Induction for gestational diabetes: what’s the evidence?
Is there any evidence of benefit for induction for gestational diabetes? That’s a question I hear a lot. Women who have been told that they have gestational diabetes are often also offered early induction of labour. But is there any…
The benefits of midwifery care
Another study has shown that receiving pregnancy care from a midwife can reduce the chance of having problems, says Sara Wickham.
Why your estimated due date might need a rethink
In the olden days, before smartphones and apps, I had quite the collection of cardboard pregnancy calculators. Around the time that I started researching estimated due dates, induction of labour, and the evidence relating to this (which was in about…
The madness of modern measurement
The madness of modern measurement. True stories of situations in maternity care where machine ‘knowledge’ overrides human knowledge, even though it’s wrong.
A revelation that every birth worker needs to know about gravity and placental transfusion
Do we really need to hold newborn babies at the level of the placenta so that gravity can assist transfusion? No, according to new research.
Birth trauma research
Sara Wickham looks at birth trauma research which highlights the experiences of women and shows how important it is that we look at this area more closely.
Are there good reasons to induce labour?
Are there good reasons to induce labour? That’s a question often posted when I talk or write about labour induction. It’s an understandable question. I have spent more than twenty years writing about how induction isn’t always beneficial. I’ve often…
Freebirth – the evidence
Sara Wickham shares studies and discussions relating to freebirth or unassisted birth and the women who opt for this.
Can I say no to vaginal examination?
Sara Wickham offers resources for questioning vaginal examination, both from her own work and other research, websites and organisations.
Induction for big baby: what’s the evidence?
Been offered induction for big baby? This is increasingly common. Pregnant women are told that a scan shows that their baby is bigger than average, and induction is recommended. If they decline, they may be offered a planned caesarean instead.…
Anti-D resources
This post offers links to all of the group B strep resources on Sara Wickham’s website, including articles, blog posts and a few external resources.
What’s the chance of having another PPH?
What’s the chance of having another PPH, if you’ve had one before? For some women, that’s an important question. Women who have had a previous postpartum haemorrhage (PPH, or excessive bleeding after birth) are often advised to have their future babies…