She needs a bed first
Record observation is disabled until she has a ward admission, and the page says why: “Observations are recorded against a ward admission. Admit her to a bed to start the labour chart.” A woman showing Not admitted on the labour board cannot be charted.Chart an observation
1
Select Record observation
The sheet is headed Labour observation and names her.
2
Set Observed at
The field states the rule: “When the observation was MADE, not when it is being typed.” A future time is refused.
3
Labour progress
Cervical dilatation, Contractions per 10 minutes, Contraction strength and Contraction duration. For a single baby the sheet also asks for Head descent (fifths palpable), Moulding and Caput in the fetal section below.
4
Fetal condition
Fetal heart rate, FHR decelerations, Liquor, Presentation, Position, Moulding, Caput and Head descent. Leave a field blank if it was not assessed; blank is kept as “not recorded”, never as normal.
5
Maternal condition
Pulse, Blood pressure, Temperature, Urine volume, Urine protein and Urine acetone.
6
Treatment
Oxytocin running, Drugs and IV fluids, and Notes.
7
Select Chart observation
It confirms Observation charted — “It is on the labour chart.”
An entirely empty observation is refused: “Record at least one observation — an empty entry would look like a gap that was covered.” Chart what you took, and leave the rest blank.
The cervicograph
Cervical dilatation and head descent against hours since the onset of active labour — not against the clock. The card states where hour zero comes from: the recorded onset of active labour, or, where none is recorded, the first observation at the active-phase threshold.Head descent
Head descent is drawn on the same graph as on the paper partograph: hollow circles on a dashed line, with the number of fifths palpable read off the right-hand axis (5/5 down to 0/5). As the head comes down the descent line falls while the dilatation line rises. A corrected descent is kept on the graph, hollow and dashed, the same way a corrected dilatation is.Two charting systems, and they disagree on purpose
The chart carries a badge naming which is in force, every time, because the two judge differently and a reader who does not know which is speaking cannot read the flags at all. Your hospital chooses which one it runs — see Choose your labour chart.
The Labour Care Guide draws no alert or action line because WHO retired the fixed 1 cm/hour gradient in 2020 — it over-diagnosed slow progress. The chart says so under itself, so its absence reads as the guideline rather than as a fault.
The same reading can therefore be a flag on one chart and nothing at all on the other. A fetal heart rate of 115 bpm, recorded once, is Fetal heart rate below the reference range on the classic chart and no flag on the Labour Care Guide.
The chart is measured against whichever system is set at the moment it is opened. Nothing is recalculated, nothing is migrated and no observation changes — so a hospital that switches charts changes what its charts say about labours already in progress. The badge on the Cervicograph is always the answer to “which one am I reading”.
Gaps are gaps
Nothing is interpolated and nothing is carried forward. The notes under the chart print how many plots stand, the longest interval between plots, and how long ago the last observation was — with the point spelled out: “the segment between two plots joins them, it does not stand for observations in between.”The flags are advisory, and silence is not reassurance
Findings appear under the chart with the values that fired them, headed Advisory findings — read them, and dismiss any you disagree with. Nothing here is a decision. Each carries the stage it belongs to. With none, the chart says: No flags from what is recorded. That is not a statement that the labour is progressing normally, and it does not mean an observation was taken.Labour observations
The matrix is one column per charted observation, one row per parameter. Its caption: “Each column is one charted observation, and every value the observation recorded is shown, as recorded — nothing here is judged; the findings are under the cervicograph.” Every field on the observation sheet has a row, grouped as on the paper partograph:
Values read the way the sheet offered them — liquor as Clear, Meconium — light, Blood-stained and so on, urine protein and acetone as Negative, Trace, 1+ to 4+. Cervical dilatation is listed here as well as on the graph, because the graph only places readings from the onset of active labour onwards; an earlier reading is still on the matrix. On a phone or tablet the matrix scrolls sideways inside its own box, with the parameter names held in place on the left.
- Each column header carries the time and + the interval since the previous one — stated, never judged.
- A parameter nobody has charted reads not recorded on any observation — never a zero, never “normal”.
- Only the most recent observations are shown; where earlier ones are off the end it says Showing the most recent … observations · … earlier not shown.
- An entry with no usable time cannot be placed on the chart and is surfaced as unplaced rather than dropped.
- The bottom row carries a Correct button under each standing observation — see below.
- Empty: No labour observations have been charted yet.
Correct an observation
The word is deliberately never “Edit”. A correction adds a new observation that supersedes the original — both stay on the chart, and the reason is what makes the pair readable. The matrix’s own footnote says it in full:Correct does not edit an observation and does not remove it. It opens a new observation that supersedes the one you picked, with a reason — the original stays here, struck through, beside its correction. An observation that has already been corrected offers no Correct: correct the observation that superseded it instead.
1
Find the column and select Correct
The bottom row of Labour observations is labelled Correct — “adds a new observation; the original stays” — with a button under each standing column.
2
Check the time
The sheet is headed Correct an observation and names which one. It opens on the original’s time, not on now, because you are re-stating what was found at that moment.
3
Enter what should have been recorded
The same fields as any observation. Enter the values as they should stand.
4
Say why in Why this is being corrected
Required. Above the first field the sheet restates what is about to happen: “This writes a new observation that supersedes … The original is not changed or removed — both stay on the chart, and the reason below is what makes the pair readable.”
5
Select Chart correction
It confirms Correction charted — “The original stays on the chart beside it, struck through.”
One observation can be corrected only once. A column that has already been superseded shows corrected in place of the button rather than a control that would fail. If a correction itself was wrong, correct the correction.
What a struck-through column means
The original keeps its place — drawn hollow and dashed on the cervicograph, struck through in the matrix, with the correction’s reason on the cell. The matrix states it: “Struck through is an observation a later entry corrected. It stays on the chart: the record of what was believed at the time is part of the record. Hover a cell for the correction’s reason.” That is the whole point — a reader can see what was believed at the time, not just what is believed now.Check it worked
- A new column appears at the right of Labour observations, at the time you set, with every value you charted in its row.
- The dilatation and head descent you charted are new plots on the Cervicograph.
- Last observation on the labour board resets, and the count rises.
If something goes wrong
Record observation is greyed out
Record observation is greyed out
She has no ward admission. “Observations are recorded against a ward admission. Admit her to a bed to start the labour chart.”
A partograph is charted against an admission. Admit her before charting labour.
A partograph is charted against an admission. Admit her before charting labour.
The same cause, from the server: the admission went away, or was never linked to the delivery record.
An observation can't be recorded in the future.
An observation can't be recorded in the future.
Observed at is ahead of now. It takes the time the observation was made.
Record at least one observation — an empty entry would look like a gap that was covered.
Record at least one observation — an empty entry would look like a gap that was covered.
Every field was left blank. Chart at least one value.
The cervicograph is empty although I have charted observations
The cervicograph is empty although I have charted observations
The chart plots cervical dilatation and head descent against time since the onset of active labour. Observations with neither, or taken before the onset, appear in the matrix but have nothing to plot. The empty chart states its own reason.
This pregnancy record is closed, so no further labour observations can be charted against it.
This pregnancy record is closed, so no further labour observations can be charted against it.
The pregnancy record was closed. Nothing further can be added to it.
Say why this observation is being corrected.
Say why this observation is being corrected.
“The original stays on the chart, so the reason is what makes the pair readable.” Write what was wrong with the original.
FAQ
Can I choose which charting system we use?
Can I choose which charting system we use?
Yes. The clinic owner sets it once for the whole hospital, on the Partograph card under Settings → Facility. The card compares the two side by side before you commit — see Choose your labour chart. Every chart carries a badge naming the one in force.
We changed the chart while a woman was labouring — what happened to her chart?
We changed the chart while a woman was labouring — what happened to her chart?
Nothing was rewritten. Her observations are untouched; they are simply measured against the new system from the moment you save, so flags can appear or disappear without anyone re-examining her. The card says so before the save and again in the confirmation.
Why is there no alert line on our chart?
Why is there no alert line on our chart?
You are on the WHO Labour Care Guide (2020), which retired the 1 cm/hour line. Its absence is the guideline, not a fault — the chart says so under it. If you want those lines, the owner can switch the hospital to the Classic partograph (alert and action lines).
Can I delete an observation I charted by mistake?
Can I delete an observation I charted by mistake?
No. The chart is append-only — nothing is removed. Use Correct instead: the mistake stays, struck through, beside what should have been recorded and the reason.
Does a flag escalate anything or tell anyone?
Does a flag escalate anything or tell anyone?
No. Flags are shown with the values that fired them and nothing else happens. Reading them and deciding is yours.
Why is the x-axis hours and not the time of day?
Why is the x-axis hours and not the time of day?
Progress is judged against how long the active phase has run, so the chart is drawn in hours since its onset. Each observation’s clock time is on its column in the matrix.
Twins, triplets and more
The mother has one set of observations; each baby has their own. At the top of the labour chart, Babies in this pregnancy shows how many babies the pregnancy record holds. If it is wrong, or a twin is found in labour, select Change, choose the Number of babies, say Why this is being changed, and save. The number can’t go below a baby who already has observations on the chart, and the change is recorded with your reason. If the pregnancy was marked as multiple without a number, the chart counts two until you set it. With more than one baby:- Labour observation shows one Fetal condition block per baby, named Twin A and Twin B for two babies and Baby 1, Baby 2 and so on for three or more. Each block has Fetal heart rate, FHR decelerations, Liquor, Presentation, Position, Moulding, Caput and Head descent. A block you leave empty saves nothing for that baby. Head descent, moulding and caput are usually assessed only for the baby that is presenting, so a second baby’s fields are often blank until the first is born.
- Labour observations shows a Fetal group for each baby, for example Fetal - Twin A and Fetal - Twin B. The mother’s rows appear once.
- A Fetal heart rate chart below the cervicograph draws one line per baby, each with its own marker shape and line style and a label at its last reading, over the shaded reference range of the chart in use. Select Twin A or Twin B above the cervicograph to choose whose head descent it shows.
- Findings about a baby’s heart rate or liquor name the baby, for example “Twin B: Fetal heart rate below the reference range”. Nothing compares one baby with another.
- If the babies share one sac, turn on The babies share one sac in the Change sheet. Liquor is then recorded once, for the first baby.
- When you record a birth, Baby on the labour chart links each birth to the baby you monitored. It is optional and defaults to the birth order. A labour can hold up to 8 babies.