• Encourage obstetric team to warn neonatal team of expected problems well in advance
• Decide who should attend (e.g. first on-call, middle grade or consultant), and degree of urgency

Neonatal team should attend the following deliveries:

• Non-reassuring electronic fetal monitoring trace, as assessed by obstetric team
• Significant fresh meconium in liquor
• Major congenital abnormalities (minor abnormalities will wait until working hours)
• Vacuum extraction or instrumental deliveries performed for fetal reasons (see below)
• Preterm delivery <36 weeks’ gestation
• Severe pre-eclampsia with seizures
• Antepartum haemorrhage
• Moderate-to-severe Rhesus disease
• Unexpected breech delivery
• Any delivery under general anaesthesia

It is not necessary for neonatal team to attend the following deliveries:

• Elective caesarean section under regional anaesthesia
• Meconium staining of liquor 
• Planned breech delivery (including caesarean section under regional anaesthesia)
• Twins (>36 weeks)
• Pre-eclampsia without seizures 

The following factors may require neonatal team to attend birth or assess baby soon after birth (see antenatal plan in maternal notes)

• Maternal illness likely to affect baby:
  
  • diabetes mellitus
  • thyroid disease 
  • systemic lupus erythematosus
  • myasthenia gravis
  • myotonic dystrophy
  • hepatitis B carriage
  • intrapartum antibiotics indicated but not given, or given <4 hr before delivery 
  • HIV
  • HELLP syndrome
  • suspected sepsis treated with IV antibiotics 
• Maternal medications that may affect baby e.g. antidepressants
• Maternal substance abuse
• Neonatal alerts: 
  
  • abnormal antenatal scans
  • low-birth-weight baby <2.5 kg
• Pregnancy and past history
  
  • prolonged rupture of membranes
  • polyhydramnios
  • previous baby/perinatal death
  • family history of genetic or metabolic abnormalities