WHO next‐generation partograph: revolutionary steps towards individualised labour care

WHO next‐generation partograph: revolutionary steps towards individualised labour care?

“…In particular, we applaud the World Health Organization (WHO) for their underlying Better Outcomes in Labour Difficulty (BOLD) project, which has revealed the urgency of delaying the onset of the active phase of the first stage of labour from 3–4 cm of cervical dilatation to at least 5 cm 3 . We do agree that the previously premature designation was ‘a major iatrogenic cause of apparent poor labour progress and unnecessary interventions’, which has contributed to the epidemic of caesarean sections in many countries globally 1 . For the Labour Care Guide (LCG) to catalyse change, we urge the WHO to consider three major concerns, relevant for labour practice, before any further LCG implementation.…”

“…In their recent commentary, Hofmeyr et al. anticipate that departure from the familiar partograph ‘may provoke anxiety and even antipathy among healthcare professionals’ 1 . We agree that change is urgently needed to reach beyond the coexistence of ‘too little, too late’ and ‘too much, too soon’ care during childbirth 2 .…”

WHO next-generation partograph: revolutionary steps towards individualised labour care?

“…Hofmeyr et al anticipate that departure from the familiar partograph "may provoke anxiety and even antipathy among healthcare professionals". 1 We do concur that change is urgently needed to reach beyond the co-existence of too little, too late and too much, too soon care during childbirth. 2 In particular, we applaud the World Health Organization (WHO) for their underlying Better Outcomes in Labour Difficulty (BOLD) project, which has disclosed the urgency of delaying the onset of the active phase of the first stage of labour from 3-4 centimeters of cervical dilatation to at least 5.…”

“…3 We do agree that the previously premature designation was "a major iatrogenic cause of apparent poor labour progress and unnecessary interventions", which has contributed to the epidemic of caesarean sections in many countries globally. 1 For the Labour Care Guide (LCG), however, to catalyse such change, we urge WHO to consider three major concerns before further LCG implementation.…”

“…Therefore, one may question the claim that it sets off "revolutionary steps towards individualized labour care". 1 Maternity units in low-and lowermiddle income countries are increasingly congested and the human resources crisis is tremendous. 7,8 As we have previously disclosed, it is just impossible to follow the LCG's surveillance regime if caring for more than two women simultaneously.…”