Barriers to the universal application of the portograph for labour managent: A review of the issues and proposed solution

Abstract

The Partograph is a simple clinical tool for recording observation in first stage active phase labour aiming to alert staff who provide care in labour to deviation in labour progress as well as in the wellbeing of mother and baby. Due to the devise of the alert and action line and the protocol for the use of the Partograph, there is early alert to complications (alert line) and the eventual treatment (action line), is by the staff with the requisite skill in order to ensure good feto-maternal outcome. This principle of the Partograph has not been clearly understood. The main reason for this misunderstanding is poor knowledge of why and how the Partograph was created. This is why there are the debate and consequent lack of a consensus over several issues like the number of hours of separation
between the alert and action lines; use of the alert and action line in a tertiary centre; the time for artificial rupture of fetal membrane and the time for commencement of oxytocin augmentation to correct slow labour. These debates which constitute the barriers are all unnecessary because the facts which should guide opinion are revealed by a revisit to the history of the Partograph which will help to establish the reasons for each actions and procedure for the use of the Partograph. Finally, poor knowledge of how to use the Partograph to conduct labour is the greatest barrier for now. It is concluded that removing the barrier is best by concerted training on how to use the Partograph to all staff cadre involved in labour management.

Keywords: Reducing Barriers to the use of Partograph for labour care.