Consider the following when reviewing labour history and considering the possible need for intervention for labour delay:
o Parity and previous labour history
o Nutrition and hydration
o Bladder status
o Maternal position, mobility and behaviour
o Support and birth environment
o Continuity of carer
o Woman’s expectations and wishes
o Pain and exhaustion
o Fetal heart rate assessment
o Contraction length, strength and frequency
o Cervical dilatation and change
o Position and descent of presenting part
o Induced or spontaneous labour
• Delay is diagnosed when the woman has progressed less than 0.5cm per hour over a 4 hour period, however, delay may be diagnosed earlier if the history and clinical picture warrants earlier examination
• Arrange review by obstetric team and midwifery team leader when delay in progress is diagnosed and discuss situation with woman and her supporters. Referral and consultation with medical staff should be according to ACM guidelines
• Determine management according to the woman’s parity, preferences, and her consent to recommendations, as well as the suspected cause of delay
• Manage as per flow chart (Appendix)
• DOCUMENTATION
• Partogram
• Integrated clinical notes
• ObstetriX
• EDUCATIONAL