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I am on placement in a case-loading team at Kings and we are under obligation to use the partogram at home births exactly as we would in hospital. I have seen this done regularly. The only exception is if you arrive and the woman is fully. This is now hospital policy. XO From: Sandall, Jane Sent: Wednesday, August 03, 2011 4:14 PM To: [log in to unmask] Subject: Re: query about the use of vaginal examination in labour and/or the use of the partogramme Dear all I wonder would anyone be able to say whether the partogram is used in midwife-led and freestanding units and at home births in their settings?? bw Jane _______________________________________________ Jane Sandall Professor of Social Science and Women's Health & Programme Director (Innovations) NIHR King's Patient Safety and Service Quality Research Centre Division of Women's Health, School of Medicine, King's College London 10th Floor, North Wing, St. Thomas' Hospital, Westminster Bridge Road LONDON SE1 7EH Tel: 020 7188 8149 Fax: 020 7620 1227 Mobile: +44(0)7713 743150 e-mail:[log in to unmask] Skype: jsandall http://www.kingspssq.org.uk/ http://myprofile.cos.com/sandall http://www.kcl.ac.uk/schools/medicine/research/wh/ http://www.kcl.ac.uk/about/campuses/st-thomas.html PA Jacqui Morey Tel: 020 7188 3639 Email: [log in to unmask] -------------------------------------------------------------------------------- From: A forum for discussion on midwifery and reproductive health research. [[log in to unmask]] On Behalf Of Briege Lagan [[log in to unmask]] Sent: 02 August 2011 09:34 To: [log in to unmask] Subject: Re: query about the use of vaginal examination in labour and/or the use of the partogramme Hi Soo In units where I work as bank midwife to maintain my clinical skills, the partogram is only commenced when the woman is in established labour. When the woman is in early labour a partogram would not be used and yet VE's would still be performed to assess progress. In answer to your second question, in essence yes it would be used in a decision on whether to intervene but the overall clinical picture/history (past and present obstretric) would also be incorporated into the decision. Briege Dr Briege M Lagan RM, PhD EUROmediCAT Research Fellow Room 12L10C Institute of Nursing Research University of Ulster Jordanstown Campus Newtownabbey County Antrim BT37 0QB Northern Ireland Tel: 44 (0)2890368318 Fax: 44 (0)2890368341 Email: [log in to unmask] -------------------------------------------------------------------------------- From: Soo Downe <[log in to unmask]> To: [log in to unmask] Sent: Tue, 2 August, 2011 8:34:00 Subject: query about the use of vaginal examination in labour and/or the use of the partogramme Dear all We are completing a protocol for a review on the value of the vaginal examination as a measure of progress in labour. We have been advised that the VE is never used without the partogramme (and without attention to all the elements on the partogramme). From our clinical experience, we are not sure that this is the case - we have practical experience of the VE being used as a measure of progress in labour without reference to the partogramme (even where it is part of the routine recording process) but our experience may well be very limited. We would be very interested in your experience in the following areas: 1. In your experience, is vaginal examination ever used on its own, without using a partogramme? 2. Where the partogramme is used as a record, are all the elements of it usually used in a decision on whether to intervene? Many thanks for your advice All the best Soo