Exploring knowledge, attitudes and utilisation of the partograph by midwives and obstetricians in a regional hospital in the eThekwini District.

Abstract

Introduction: A partograph, alternatively called labour graph, is a simple pre-printed paper form on which midwives and obstetricians record labour observations. These observations consist of foetal condition vital signs, features of progress of labour, maternal condition vital signs and therapeutics undertaken in the course of labour. Improper use of the partogram was a major avoidable factor in women dying as a result of puerperal sepsis and postpartum haemorrhage. Purpose of the study: The purpose of this study was to explore and describe the knowledge, attitudes and utilization of the partograph by midwives and obstetricians in a regional hospital in the eThekwini district. Methodology: This is a quantitative descriptive study. Data collection was done in October and November, 2011. The first part of the study, was prospective in nature, data were collected from self-administered questionnaire which explored the knowledge, attitudes and utilization of the partograph by midwives and obstetricians. The second part of the study was retrospective in nature, data were collected by a chart audit of partograms from the maternity files of women who delivered vaginally in September, 2010 at the study site. Results: The partograph was used to monitor the progress of labour in all the deliveries, but the recording of variables was incomplete in 38 (38%) partograms, whereas 62 (62%) partograms were completely recorded. The incompletely recorded parameters included temperature, pulse, blood pressure and urine estimation, date and time of rupture of membranes. There were differences in the responses of obstetricians compared to midwives, not only in the use of partograph, but also in the recording of data. Conclusion: It is evident therefore, that, despite the wide use of the partograph to monitor women in labour, the recording, interpretation and eventual interventions are still deficient, and that more need to be done in order to address this protracted weakness in the management of labour.