Nobody arrives here by inference
Assessing her in labour, or starting her delivery record, is the act of putting her on the board. There is no ward that moves women across, no sweep at term, and nothing that guesses from a gestation. The board says it in its own words: “Nobody on this list is in labour until someone starts her delivery record.” That is why the two lists below In labour are context and not claims. A woman on either is not stated to be labouring — she is simply findable.What you’re looking at
The heading reads Labour Ward, and under it: Women with a delivery record open, and the pregnancies at or past term behind them. On a hospital with no open pregnancy at all it reads No open pregnancy records — “Open one from Today’s Clinic. The labour board draws on the same records.”In labour
Every woman with a live delivery record, longest in labour first. The caption states the rule: “A woman is here because a delivery record was opened for her, and stays until her pregnancy record is closed.” With nobody on it: Nobody is on the labour board — “Nobody is added automatically.”The Record column describes the paperwork, not the labour. Labour in progress means somebody has not finished typing — it is not a statement that the birth is incomplete. And Nothing charted means nothing is known, never that the observations were normal.
Assessed on admission and Labour in progress are different facts, not two words for one. The first means a midwife has examined her and her record is open; the second means somebody has started writing the birth up. Only the second is counted as a delivery anywhere in the register or on the coverage figures — a woman still labouring is never counted as a birth that happened.
Expected
Open pregnancies with no delivery record, at or past term — plus any whose dating cannot be used, which are shown deliberately rather than dropped, because an unusable due date would otherwise be indistinguishable from an early booking and she would be invisible on the ward that has her. The caption is on the screen: “Open pregnancies at or past term, plus any whose dating cannot be used. Nobody on this list is in labour until someone starts her delivery record.” Columns are Patient, Gestation, Due date, and the two actions — Triage and Start delivery record. With none: “No open pregnancy has reached term, and none is missing a usable due date.”Not expected yet
Every remaining open pregnancy — before term, with usable dating. The caption states exactly what it is and is not: “Open pregnancies before term. Nobody here is in labour or due — but labour can start early, and starting her delivery record here is the same act as above.” Expected is deliberately not widened to include them, because it answers a different question: who is due. This list answers “where is she”, and it refuses nobody.- The count beside the heading is all of them, not the number on screen.
- A search box — Find by name or file number — reaches anyone.
- Eight rows show at a time, with Showing 8 of 34 underneath and “Type a name or file number to find anyone else.” Nothing is hidden, only unlisted.
- With nobody left over: “Every open pregnancy is on one of the lists above.” A search matching none: “No open pregnancy before term matches that.”
The board keeps its own time
Gestation, how long she has been labouring and how long since the last observation are all worked out fresh every minute while the page is open. The footer says so: “Gestation and every elapsed time on this board are recalculated as the clock moves; nothing here is a stored figure.”Find somebody on this list
A search box and filter buttons sit above the board. They narrow what is drawn; they never change what is recorded.- Search matches on name and patient number, in any order — typing
bello 0042finds Amina Bello with number MAT-0042. Case does not matter, and part of a word is enough. - One search covers all three lists. You do not have to know which list a woman is on to find her — which is what a search is for.
- Gestation narrows to Preterm, Term, Post-dates or Dating unavailable.
- Risk narrows to Has a risk factor or Multiple pregnancy.
- The count beside each heading stays the full count. A filtered board can never read as an empty ward.
- Clear filter empties one; Clear all appears once anything is narrowing the list, with a count of how many things are.
A list that a search has emptied says so, and tells you how many records it is drawn from. It never reads as an empty ward — that is a different statement, and you would have no way to tell the two apart.
Put a woman on the board
There are two doors and they are the same permission. Triage records the examination you did on admission and opens her record; Start delivery record opens the record with nothing written down, for the woman who arrives fully dilated and is not a form to fill in first.Triage her in labour
1
Find her in Expected, or in Not expected yet
At or past term she is under Expected; before term she is under Not expected yet, where the search finds her by name or file number. If she is on neither, she has no open pregnancy record — open one from Today’s Clinic first.
2
Select Triage
Labour assessment opens as a sheet, headed with her name and the line “The examination on admission — one moment, recorded once. Chart what changes after this on the partograph.”
3
Record when and how labour started
Labour started takes a date and time — leave it blank if she cannot say, and nothing is worked out from it. How labour started offers Spontaneous, Induced and Caesarean before labour, with Not recorded as the default.
4
Record her observations and the examination
Her observations takes blood pressure, pulse, temperature, respiratory rate and SpO₂. The examination takes cervical dilatation, contractions in ten minutes, membranes, presentation and the fetal heart rate, with Danger signs as a comma-separated list underneath. For a twin or higher multiple pregnancy, The examination also shows a block for each further baby, named Twin B, or Baby 2, Baby 3 and so on, with that baby’s Presentation and Fetal heart rate; the first baby’s fields stay in the main grid.Every field is optional and every box left alone stays empty — an untouched dilatation box is never stored as “0 cm”. Nothing here is scored, flagged or acted on automatically: danger signs are shown to the people reading her chart.
5
Give her a bed, if there is one
A bed on the labour ward lists the free beds on a ward set up as a labour ward, with Do not admit yet as the default. Choosing a bed is optional — the assessment is recorded either way — but choosing one asks for two more things: the required Attending clinician, “Who is responsible for her while she is admitted,” and an Admission note.
6
Select Record assessment
It confirms Assessment recorded — “She is on the labour board and admitted to the bed you chose”, or “She is on the labour board. Admit her to a bed when one is ready.”
The observations go onto her chart, not just onto this board. They are recorded as an encounter, so they appear on her clinical chart alongside every other set of observations, and a doctor can open her from the visit. That is also what makes them withdrawable — see Retract a delivery or birth record.
One assessment per labour. A second attempt is refused with “This labour already has an admission assessment. Chart what has changed on the partograph rather than assessing her again.” That is not a limitation — the admission examination is one moment, and everything after it belongs on the labour chart, which is built to hold a series.
Or open the record with nothing in it
1
Select Start delivery record
It is the same act from either list. Confirm at Start a delivery record — “…moves onto the labour board. The record opens as a draft — it does not claim she has delivered, and nothing else about her pregnancy changes.” Select Start record.
2
She moves to In labour
It confirms On the labour board — “A draft delivery record is open. Complete it as the labour progresses.” Nothing is filled in yet; the record is opened empty on purpose.
Open her labour record
Select Labour record from the ⋯ menu on her row. That page carries the delivery record and the labour chart together — see The labour record.Book a theatre case
An emergency caesarean is booked from her row, without leaving the board and without searching for her again on the theatre list.1
Select Book theatre case from the ⋯ menu
Where she already has one, the menu reads Book another theatre case instead — booking again is allowed, because a return to theatre after a haemorrhage is a real second case.
2
Read what is already booked
Any case standing against her is named above the form before you fill anything in — case number, operation, status and time — under She already has a theatre case, with the line “Booking again creates a second case. It does not cancel or replace the one above.”Nothing is refused here. What must never happen is a second caesarean booked because the first was invisible.
3
Name the operation
Operation is pre-filled with Emergency caesarean section. Change it for anything else.
4
Check the urgency
Urgency is pre-set to Emergency — “Pre-set to emergency. Change it for a planned section.” The other choices are Urgent and Elective. ASA grade is optional.
A planned section booked as an emergency corrupts the theatre list and the caesarean audit. A woman admitted the night before for an elective section is on this board like anyone else, and the default does not know that. Change it.
5
Pick a theatre and a time
Theatre offers your active rooms — “A theatre can be assigned later. A clash is refused when the case is saved.” Start and End are proposed as now and an hour from now; the end must be after the start.Where there is nothing to pick, the list is greyed out and says which of two things is true: “No theatre at this clinic is open for booking”, or “The theatre list could not be loaded”. Either way the case still books, and a theatre is assigned to it later.
6
Add the care team and any notes
Primary surgeon and Anaesthetist can each stay Unassigned. Pre-operative notes is free text.These two are greyed out with a line under them when there is nobody to pick — “Nobody at this clinic has a name on file to pick”, or “The staff list could not be loaded”. The case still books; the team is assigned to it later.
7
Select Book case
Where a case already stands the button reads Book another case. It confirms by naming the generated case number — Case … booked — and adds “It is on the theatre list. Record how she delivered on her delivery record when the birth is done.”
Booking the case does not write up the birth. The delivery record is still where how she delivered is recorded — see The labour record.
The case goes onto her delivery record
Booking from the labour board also writes the case onto her delivery record, so the birth and the operation it happened in are one thing rather than two. The confirmation says which happened: “It is on the theatre list and on her delivery record.” On the board the case then reads · on record, and the booking sheet badges it On her delivery record. This only ever fills a gap. Where her delivery record already points at a case, a second booking is still made and put on the theatre list, but the record is left pointing where it was — the confirmation says “Her delivery record still points at the case that was already on it.” That is the ordinary result of a return to theatre: a woman taken back for a haemorrhage has two cases, and the one she delivered in is the one her record keeps. A case booked before anyone opened her delivery record is not added to it, because there is nothing yet to add it to. Book it as normal; the record it belongs to is the one the birth is written up on.Sign a completed record
Where a record reads Recorded · unsigned, a Sign record button appears on the row. Confirm at Sign the delivery record — “Signing is your attestation that this is the record of … ’s birth. It closes the record to editing — after this, a change is recorded as an amendment.”Who can do this
Hiding a button is a convenience — the check runs again when the act is submitted, and a refused attempt is written to the audit log. See Permissions.
Check it worked
- She has moved from Expected to In labour, with Record reading Labour in progress.
- In labour for starts counting once an onset is recorded on the delivery record.
- Last observation changes from Nothing charted as soon as you chart one.
Common issues
A woman in labour is not on the board
A woman in labour is not on the board
Nobody is added automatically. Find her under Expected and select Start delivery record. If she is not there either, she has no open pregnancy record.
She is not in Expected although she is at term
She is not in Expected although she is at term
Expected lists open pregnancies only. If her pregnancy record has been closed, or was never opened, she does not appear on the board at all — check Today’s Clinic.
I cannot see her in Not expected yet
I cannot see her in Not expected yet
Only eight rows show at a time. Type her name or file number into Find by name or file number — the count beside the heading is everyone, and the line under the table says how many are not listed.
In labour for reads Onset not recorded
In labour for reads Onset not recorded
No onset time is on her delivery record yet. Open Labour record and set Labour started.
Where reads Not admitted
Where reads Not admitted
She has no ward admission linked to the delivery record. That is a real situation — a birth before arrival, or a site not running the inpatient module — but the labour chart cannot be started without one.
No ward is set up as a labour ward. Set one under Settings → Wards.
No ward is set up as a labour ward. Set one under Settings → Wards.
The assessment sheet can only offer beds on a ward whose purpose is set to Labour ward. It deliberately does not fall back to a ward set to Maternity — that would nominate an antenatal ward as a delivery ward because nobody had said otherwise. Set one under Wards. The assessment records either way.
Your wards have not been given a type yet…
Your wards have not been given a type yet…
Your wards exist but none has had its purpose set, so none can be identified as the labour ward. This is a different message from “no ward is set up as a labour ward” on purpose: the first is a setup step you have not done, the second is a fact about how your hospital runs. Set them under Wards.
Every bed on the labour ward is taken
Every bed on the labour ward is taken
There is a labour ward and it is full. Record the assessment now — she goes onto the board regardless — and admit her from the ward screen when a bed frees up.
The assessment was saved. The bed was not.
The assessment was saved. The bed was not.
The examination is recorded and she is on the board; only the admission failed, and the reason is printed under that heading. Do not record the assessment again — it is already there, and a second attempt will be refused. Admit her from the ward screen.
This labour already has an admission assessment.
This labour already has an admission assessment.
Somebody has already examined and admitted her. The admission assessment is one moment and is recorded once; everything after it belongs on the labour chart.
This record still says she is in labour. Record the delivery first…
This record still says she is in labour. Record the delivery first…
You are trying to add a baby to a record that has not been moved on from the assessment. Open her labour record, fill in when the birth was and how it was conducted, then add the baby. A baby recorded against a labour still in progress would be left out of the birth and stillbirth figures.
That theatre is already booked for part of this time. Choose another room or another slot.
That theatre is already booked for part of this time. Choose another room or another slot.
Another case holds that theatre across part of your window. Pick a different room, or move the time. The clash is checked when the case is saved rather than when you pick the room, because a check made earlier can be stale by the time the booking lands.
That admission belongs to a different patient.
That admission belongs to a different patient.
The stay carried in from her delivery record is not hers. Open her labour record and check the admission on it before booking again.
The theatre list could not be loaded / The staff list could not be loaded
The theatre list could not be loaded / The staff list could not be loaded
Something went wrong reading that list — this is not a clinic with no theatres or no staff, and the booking sheet says so rather than showing you an empty picker. Book the case anyway. The case number, the time, the patient and the admission are all recorded correctly; the theatre and the care team are assigned afterwards, from the theatre list. Close the sheet and open it again to retry the read.
No theatre at this clinic is open for booking
No theatre at this clinic is open for booking
Every theatre is under maintenance or closed, or none has been added yet. This is a different message from “The theatre list could not be loaded” on purpose. Add or reopen a room under Theatre, and book the case in the meantime — it does not need a theatre to exist.
FAQ
When does a woman leave the board?
When does a woman leave the board?
When her pregnancy record is closed, or if the delivery record is retracted — see Retract a delivery or birth record, after which she returns to Expected if she is at or past term. Recording a birth does not remove her: the row shows Born … and the record’s own state instead.
Where does she go after the birth?
Where does she go after the birth?
She appears on Postnatal as soon as the delivery record carries a Time of birth, with the four WHO contacts and a row for each baby. She stays on this board as well until her pregnancy record is closed.
Why is somebody with an unusable due date in Expected?
Why is somebody with an unusable due date in Expected?
Deliberately. Dropping her would make an unusable due date look the same as an early booking, and she would be invisible on the ward that has her. The row is labelled Dating unavailable.
Does the two-hour mark on Last observation mean something is wrong?
Does the two-hour mark on Last observation mean something is wrong?
No. It is a display convention that makes a long gap conspicuous. It changes no status, refuses nothing, and is not a statement about the labour.
Is a woman being assessed counted as a birth?
Is a woman being assessed counted as a birth?
No, and that is the whole reason Assessed on admission is a separate state. Every delivery figure — the number of births, the caesarean rate and the stillbirth rate on Coverage and on the register — counts a record only once it has been moved on from the assessment. A ward full of women in labour does not move any of them.
Do I have to triage her before starting the delivery record?
Do I have to triage her before starting the delivery record?
No. Start delivery record is there for exactly the woman who does not arrive in time to be assessed first. Triaging her afterwards attaches the examination to the record that is already open.
Can I start a delivery record for someone under term?
Can I start a delivery record for someone under term?
Yes. She is under Not expected yet, and Start delivery record there is the same act as on Expected — a preterm labour is admitted to the board exactly like any other.
Is the birth itself recorded here?
Is the birth itself recorded here?
The delivery record holds how the birth happened; each baby is a birth record of its own, in the Babies section of her labour record. See Babies and birth records.
Is a case booked here different from one booked on the theatre list?
Is a case booked here different from one booked on the theatre list?
No. It is the same record, with a number minted the same way, and the theatre team sees it on their own list without anybody telling them. The only thing this route adds is the admission she is labouring on, which the theatre list has no way to know.
Why does it let me book a second case?
Why does it let me book a second case?
Because a second case is sometimes right — a return to theatre after a postpartum haemorrhage is a real operation. What it does instead of refusing is show you what is already booked, before the form, so nobody books a duplicate caesarean because the first one was invisible.