The partograph -- use it!
Prolonged and obstructed labour are important causes of both maternal and perinatal morbidity and mortality. In the early 1970s, Hugh Philpot designed and developed the partograph in Zimbabwe to help prevent such problems and adverse outcomes during the active management of labour. He showed that the partograph helped to reduce prolonged labour, caesarian sections, labour augmentation and perinatal deaths. Anecdotal reports also mentioned of how the partograph made the occurrence of ruptured uteri much rarer, and implied that it had contributed to a reduction in maternal mortality. Anyone with experience of working in deprived areas where maternal care is predominantly managed by poorly supported midwives, and where the expertise for doing an emergency hysterectomy is limited or non-existent, will testify to the great value of the partogram. And yet, more than twenty years since its development, the partogram is still infrequently and inconsistently used in this country (both in rural and urban areas). (excerpt)