A STUDY TO ASSESS THE EFFECT OF PARTOGRAPH USE ON OUTCOMES FOR WOMEN IN SPONTANEOUS LABOUR AT TERM AND THEIR BABIES

Abstract

 A partograph is usually a pre‐printed form, the aim of which is to provide a pictorial overview of labour progress and to alert health professionals to any problems with the mother or baby. It has been unclear whether a partograph should be used and, if so, which design of partograph is better for women and babies.

Following the update of its global recommendations on intrapartum care in 2018, the WHO initiated a process to revise the partograph in light of recent evidence, including a new understanding of the individual variability of the progress of labours resulting in good perinatal outcomes, and the fact that many women do not experience a labour that conforms to the average rate on which the partograph design was based. A large study and corresponding systematic reviews published in this journal and subsequent analysis failed to find evidence to support the use of a cervical dilatation rate of 1 cm/hour as a screening tool to predict adverse labour outcomes. The new WHO recommendations based on the emerging evidence on normal labour progression, as well as recommendations informed by the global shift towards improving experience of childbirth, necessitated the design of a new labour monitoring tool called the WHO Labour Care Guide. WHO has also published a corresponding user's manual to support healthcare providers on how to successfully use the new tool. The Labour Care Guide is distinct from previous partograph designs in its approach to labour duration, triggers for clinical interventions and its emphasis on respectful maternity care.