The Maternity tab on a ward chart

A woman labouring on your ward is already an inpatient, so she has the flowsheets, the drug chart, the orders and the notes by being one. The Maternity tab is the one thing a ward chart could not otherwise show: her labour. It carries the delivery record, the labour chart and the babies, at the bedside, without leaving her chart.

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When the tab is there

It appears for an admission with a delivery record on that stay, or for a patient with an open pregnancy record. Two predicates, and the second is deliberate: a woman admitted at 22 weeks for hyperemesis has the tab too. The second predicate is what makes the tab reachable at all — starting a delivery record is an act performed on this tab, so a tab that required one first could never be opened. It also means a woman who goes into labour in the bed she is already in never has to leave her own chart to say so.

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What you’re looking at

The heading is the record’s own answer, not an assumption: Under the heading, on one line: her gestation (or Dating unavailable), EDD, and her parity.

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Before anybody has charted

Under a Pregnancy heading a panel says so plainly — “Nothing on this chart says she is in labour. Her pregnancy is shown here as context for whatever she was admitted for.” — followed by the risk factors Recorded at booking, or No risk factors were recorded at booking. The Delivery record card is still there, badged Not started, and it names its own consequence rather than sitting empty: “Nothing is claimed about this labour yet. Starting the record is the act that says she is in labour: it puts her on the Labour Ward board, and the midwives there work from it. Start it when she is labouring, not because this section is empty.”

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The delivery record

The card is badged Not started, In labour, Draft, Recorded, unsigned or Signed, and the button reads Start delivery record or Open record. In labour means the record was opened by an assessment on the labour ward and no birth has been written up yet — it is not a Draft, and it is counted as a delivery by nothing. It opens the same form the maternity route uses — see The labour record. The stay she is labouring on is carried in from the chart that opened it. Nobody types it, which is what lets the labour chart be charted from here at all.

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The labour chart

Labour chart sits below, with Record observation where you hold the pen. The cervicograph and the observation matrix are the same two components the maternity route mounts, reading the same schedule your hospital chose — see The labour chart. Both are mounted on an antenatal admission too, unfiltered. Each owns an honest empty state; a chart that vanished when the log was empty would be a second, quieter answer to “has anything been recorded”. A reading you supersede keeps its column, struck through. Correct appears only where you can actually write — if the entry cannot be corrected from here, no control is offered rather than one that would be refused.

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Babies

Once a delivery record exists, a Babies card lists the births against it, with a count beside the heading. Record a birth is available whether or not one is already recorded, and the card says why: “One row per baby. A twin birth is two records against this one labour, never one row for both.” With none yet: No birth has been recorded against this labour yet. If the birth records cannot be read, the card says The birth records could not be loaded with Try again, and states what that does not mean: “Nothing was read, so this is not a statement that no baby was born. The rest of this labour record loaded.” The delivery record and the labour chart above it still render.

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It needs a connection

The partograph and the delivery record are not part of the cached ward chart. Offline the tab reads The labour record needs a connection — “this is not a statement that nothing has been recorded. Reconnect to read them.” A failed read says the same kind of thing — The labour record could not be loaded, “This is not a statement that there are no observations — nothing was read” — with Try again.

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Nothing here is worked out for you

There is no fetal-heart band on this tab, no alert-line gradient, no active-phase threshold and no stage limit of its own. Every one of those belongs to the labour chart you chose, and a second copy on this surface would eventually flag a labour the cervicograph beside it did not. Gestation is the one exception, and it is arithmetic: it is worked out from the due date each time you look, along with how long ago each observation was, so a chart left open for a whole shift keeps telling the truth rather than freezing.

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Who can do this

Two layers apply, and they are different questions. Charting an observation is treated as the labour equivalent of a nursing note, so it carries no switch of its own. Recording a birth rides Record a delivery, because writing up a baby’s weight and Apgar is writing up the delivery; registering the newborn is separate because it creates a person — a patient record, a chart and a billing relationship. See Permissions.

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Check it worked

• On an antenatal admission the heading reads Pregnancy, and the delivery card is badged Not started.
• Select Start delivery record: the heading becomes Labour record, and she appears under In labour on Labour Ward.
• Chart one observation: it appears in the matrix, and Last observation changes on the labour board.
• Record a birth: a Baby 1 row appears on the Babies card and the count reads 1.

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Common issues

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FAQ