Patient or family

Reading path for expectant parents

A suggested order for reading this atlas, from before pregnancy through birth to a baby’s first months. Each step points to one page and says in plain words what that page covers. It is a reading order, not medical advice and not a care plan. It does not tell anyone what to do.

1. Chronic hypertension in pregnancy Before pregnancy. This is high blood pressure that a woman already has when she becomes pregnant, or that is found in the first 20 weeks. The page explains that decisions in pregnancy differ: some blood pressure medicines are not advised, and whether to treat mildly raised pressure has been debated. It also links to the CHAP trial, which looked at treating mild chronic hypertension in pregnancy.
2. Pre-eclampsia In pregnancy. Pre-eclampsia is a condition of pregnancy in which blood pressure rises after 20 weeks and, at the same time, there are signs that other parts of the body are affected, such as protein in the urine or problems with the kidneys, liver, blood or brain. The page uses the NICE definition and says that other guidelines and trials define it differently.
3. Nulliparity In pregnancy. NICE lists nulliparity as one of six moderate risk factors for pre-eclampsia and uses the term without defining it. NICE does not say how much it raises the risk on its own. Having more than one moderate factor is a reason NICE gives for advising low-dose aspirin. In August 2022 NICE changed an earlier wording, first pregnancy, to this term, so the two are not treated as the same.
4. Low-dose aspirin to prevent pre-eclampsia In pregnancy. In England, NICE tells clinicians to advise a small daily dose of aspirin, 75 mg to 150 mg, from 12 weeks of pregnancy until the birth, for women at high risk of pre-eclampsia and for women with more than one moderate risk factor. NICE notes that for this use aspirin has to be prescribed, and that community pharmacies in England may not lawfully sell aspirin for pre-eclampsia prevention as a pharmacy medicine. WHO gives different advice with its own risk lists. A recommendation is not an authorization.
5. sFlt-1/PlGF ratio In pregnancy. Two proteins, sFlt-1 and placental growth factor (PlGF), are measured in the same blood sample and one is divided by the other. The result is used in two different ways in two countries. In the United States, the FDA clears one version as an aid for judging, within two weeks, the risk of pre-eclampsia with severe features in women already in hospital with high blood pressure, and it is not intended for diagnosis. In England, NICE recommends named tests to help rule pre-eclampsia in or out when it is suspected between 20 weeks and 36 weeks and 6 days. The two uses are not interchangeable.
6. Antenatal corticosteroids In pregnancy, when an early birth is likely. These are steroid medicines, dexamethasone or betamethasone, given by injection to the pregnant woman. The medicine reaches the baby and helps the lungs mature, which can protect the baby’s breathing after an early birth. The mother receives the medicine and the baby is the one meant to benefit. The page covers the ACTION-I trial and the WHO 2022 recommendation, which applies only when five stated conditions are met.
7. Postpartum haemorrhage Childbirth. Postpartum haemorrhage is heavy bleeding after a baby is born. It is one of the most common complications of childbirth and a leading cause of death for mothers worldwide, and most of those deaths happen in low- and middle-income countries. The page gives two WHO figures with their own years and bases and does not combine them. It explains that bleeding is often noticed late when blood loss is judged by eye, and that WHO 2025 recommends measuring blood loss objectively. A calibrated drape is one way to measure it.
8. Tranexamic acid for treating postpartum haemorrhage After birth. This is a medicine given into a vein, on top of usual care, to women who are bleeding heavily after birth. In the WOMAN trial it lowered deaths from bleeding but did not clearly change deaths from all causes or hysterectomy. WHO recommends giving it early, within 3 hours of birth. The page is about treating bleeding that has started. WHO 2025 does not recommend the medicine to prevent bleeding in women who are not bleeding heavily.
9. Hypertensive disorders of pregnancy After birth and later in life. This page groups high blood pressure that is present before pregnancy or starts during it: chronic hypertension, gestational hypertension and pre-eclampsia. NICE puts the share of pregnant women affected by these disorders at about 8% to 10%. The page also holds one NICE statement that applies after any of them: NICE tells clinicians to advise women that a hypertensive disorder of pregnancy is linked with a higher chance of high blood pressure and cardiovascular disease later in life.
10. Care of the preterm or low-birth-weight infant The newborn period. This is the care of a baby born early or small, from birth through the first two years. It includes skin-to-skin care with a parent, feeding with the mother’s own milk, breathing support when it is needed, keeping the baby warm, and support for the family in hospital and after going home.
11. Newborn thermal care The newborn period. Thermal care means keeping a newborn warm and preventing a low body temperature. The iKMC trial measured low body temperature as a secondary outcome, using its own definition.
12. Kangaroo mother care (KMC) The newborn period. Kangaroo mother care is holding the baby skin-to-skin on the mother’s chest for long periods, together with breastfeeding.
13. Immediate kangaroo mother care The newborn period. This is starting skin-to-skin care within hours of birth, even before a small baby is fully stable, with the mother staying in the newborn unit. In the iKMC trial, babies weighing 1.0 to under 1.8 kg who started it within hours of birth were less likely to die in their first 28 days than babies who started it only after they were stable. WHO rates its recommendation to start kangaroo mother care as soon as possible after birth for babies born early or small as a strong recommendation based on high-certainty evidence.
14. Care of the preterm or low-birth-weight infant Infant follow-up. The WHO guidance behind this page covers care from birth to 24 months, including support for the family in hospital and after going home. This atlas has so far recorded only one of WHO’s 25 recommendations, immediate kangaroo mother care, so what to expect after going home is not yet covered here. Coverage is planned.