See related article by Sanghvi et al.
Over the past decade, it has been heartening to see marked increases in institutional births in many countries. However, this increase has not consistently been associated with corresponding declines in maternal and perinatal deaths.1–3 In many countries, intrapartum stillbirths and very early newborn deaths remain distressingly common. Safe, supportive, vigilant, and well-coordinated care during labor could significantly reduce the burden of such deaths.
USING THE PAPER PARTOGRAM TO AID LABOR DECISION MAKING
The partogram is a single-page, graphic record used to document key clinical information on the mother and fetus during labor and is intended to be an aid to clinical decision making. Although the World Health Organization no longer recommends using the 4-hour action line (based on 1 cm/hour increase in dilatation through the active phase of labor), it does endorse using the partogram for monitoring the well-being of the mother and newborn and for identifying risks …