Labor Chart: A Detailed Guide

A labor chart is an important tool to monitor and assess the progress of labor, allowing for timely interventions to ensure the safety of both mother and baby.

1. When is a Labor Chart Needed?

A labor chart should be recorded for high-risk cases such as:

• Severe preeclampsia, eclampsia: These conditions can affect the health of both mother and baby.

• Fetal distress: The baby is not receiving enough oxygen, risking death in the womb.

• Previous Cesarean section: Women who have had a Cesarean delivery have a higher risk of rupture of the uterine scar.

• Breech presentation: The baby is positioned upside down in the womb, making birth more difficult.

2. Calculating the Active Phase:

The active phase is the stage of strong labor with rapid cervical dilation. It is calculated from the moment the cervix is 3 cm dilated until it is fully dilated.

3. Identifying Abnormal Labor:

Abnormal labor occurs when the cervical dilation line touches or exceeds the upper alert line on the chart. This means the cervix is dilating slower than normal.

4. The Significance of the Alert Line:

• Above the alert line: Labor is progressing abnormally, and cervical dilation is slow.

• Below the alert line: Labor is progressing normally.

• Between the alert line and action line: Labor is still within normal limits.

5. Symbols on the Labor Chart:

• “T”: Membranes ruptured, amniotic fluid clear.

• “++”: Distinct caput succedaneum (swelling on the baby’s head).

• “O”: Fetal presentation.

6. Monitoring Body Temperature:

The mother’s temperature should be monitored every 4 hours to detect early signs of infection.

7. The Duration of the Active Phase:

The active phase should not exceed 10 hours.

8. Cervical Dilation Rate:

During the active phase, the minimum cervical dilation rate is 1 cm per hour.

9. The Latent Phase:

The latent phase is the stage of mild labor with slow cervical dilation. It is calculated from the onset of labor until the cervix is 3 cm dilated.

10. Fetal Presentation Monitoring:

• Low fetal station: Marked by a circle “O” on the horizontal line number “O” on the chart.

• High fetal station: Marked by a circle “O” on the horizontal line number “1”, “2”, or “3” on the chart.

11. Content of the Labor Chart:

The labor chart records the progression of labor over time, including:

• Cervical dilation.

• Fetal presentation.

• Amniotic fluid.

• Fetal heart rate.

• Temperature.

• Blood pressure.

• Pulse.

12. Normal Labor:

• Latent phase does not exceed 8 hours.

• Fetal heart rate between 120 – 140 beats per minute.

• Pulse and blood pressure within normal limits.

13. Management of Fetal Distress:

• Fetal resuscitation.

• Immediate referral to a higher level of care.

Note: The labor chart is an important tool to help doctors monitor and assess the progress of labor. However, it cannot replace direct observation and clinical examination.