In a more broader sense guidelines are generally available recommendations for physicians. Ideally, they describe treatment and decision pathways. Most guidelines for obstetrics published by the Association of the Scientific Medical Societies in Germany (AWMF, http://leitlinien.net) do not fulfill the quality requirements of the Agency for Quality in Medicine (AQuMed, http://www.aezq.de) in either their goals or their formal presentation. Currently, clinical practice is guided by a consensus of existing expert opinions. Obstetric guidelines are poorly developed at level 1. It is uncertain whether additional scientific evidence can improve already published guidelines. Nonetheless, existing guidelines should be re-evaluated and revised regularly--as has been done in some instances.