Summary

The WHO has introduced the Labour Care Guide as a next-generation tool for monitoring labour, building on experience with the traditional partograph. Studies of electronic partogram tools in low- and middle-income settings have reported improvements in documentation and, in some cases, clinical outcomes. A well-structured maternity EPR can help teams record observations, prompts and decisions in line with local policy and national standards, and can sit alongside specialist tools used on labour wards. World Health Organizationuk.growapp.org

From the paper partograph to the WHO Labour Care Guide

WHO’s Labour Care Guide is designed to modernise intrapartum monitoring and support person-centred care. It updates thresholds for labour progress, emphasises supportive care and includes guidance on recording maternal and fetal observations. WHO’s 2020–2022 materials set out how the guide is intended to be used at the bedside. uk.growapp.orgperinatal.org.uk

Many services still refer to partograph-style charts. Electronic versions, often called e-partograms or digital partographs, have been piloted and evaluated in several countries to support real-time documentation and prompts. longtermplan.nhs.uk

What studies say about digital partograph tools

Evidence from randomised and quasi-experimental studies suggests potential benefits, while noting that results depend on context, training and implementation:

• A cluster randomised trial in Kenya reported that use of an electronic partograph was associated with improved intrapartum care practices and fewer abnormal fetal outcomes. longtermplan.nhs.uk
• A pre-post evaluation in Bangladesh found that introducing a digital partograph was linked to lower rates of prolonged labour and caesarean section. NHS England Digital

These results come from specific settings and may not translate directly to every health system. They do, however, show how digital tools can support timelier recognition and response. longtermplan.nhs.ukNHS England Digital

How an EPR supports safe labour care

An electronic patient record that follows an agreed maternity information model can help teams:

• Record observations, assessments and decision points in a consistent way so that everyone sees the same picture. PRSB’s Digital Maternity Record Standard includes sections for observations, labour details, procedures, plan and actions, and newborn examinations. PRSB
• Reduce duplicate entry by capturing information once for use in handover, discharge summaries and required datasets. PRSB highlights reduced duplication and better interoperability as expected benefits. PRSB
• Support prompts and structured pathways that reflect local policy. This is important where WHO guidance is adapted to national and local practice. uk.growapp.org

Where MiRecord sits in the intrapartum picture

MiRecord is the Perinatal Institute’s electronic version of the hand-held maternity notes and is designed to support clinicians with care pathways, risk alerts and prompts, while remaining centred on the mother’s information needs. It also offers offline use and shared care, and is integrated with the GROW 2.0 fetal growth surveillance module. These are stated features on the Perinatal Institute’s MiRecord page. perinatal.org.uk

MiRecord can form the core record that travels with the mother across settings. Specialist tools used on labour wards, such as digital labour monitoring applications, can complement an EPR by supporting real-time observations at the bedside. Teams can then ensure that decisions, handovers and outcomes are documented in the main record in line with local information governance and clinical safety processes. The PRSB standard shows the key data items that an EPR should hold to support this workflow. PRSB

Wider NHS context

Digital work to improve maternity safety and data use continues across the NHS. National programmes highlight the role of better data, consistent records and timely information sharing to reduce unwarranted variation and improve outcomes for mothers and babies. NHS England+1

Practical next steps for providers

• Check your local intrapartum guidance against the WHO Labour Care Guide and your Trust’s protocols, then confirm how those requirements are reflected in your EPR templates and labour ward documentation. uk.growapp.org
• Review whether your record build covers PRSB sections for observations, labour details, procedures, care plans and newborn examinations. This helps ensure the essentials are captured and handed over reliably. PRSB
• If you use or pilot digital labour monitoring tools, agree how key decisions and outcomes flow back into the core maternity record. This preserves a single source of truth for clinical audit and reporting. PRSB