title: Managing labor using partograms with different action lines: a prospective study of women's views.
abstract: BACKGROUND
  The precise timing of medical intervention for women in prolonged labor is the subject of considerable debate. The partogram action line is a tool to assist practitioners in the correct diagnosis of prolonged labor. Despite its widespread use, the precise timing of the action line has not been rigorously studied, and women's views have rarely been sought. The aim of this study was to assess the effect on maternal satisfaction of managing labor using partograms with action lines drawn at 2, 3, or 4 hours to the right of the alert line.
  
  
  METHODS
  As part of a large pilot randomized controlled trial, women's views were explored using a specifically designed questionnaire that was completed by 615 primiparas 2 days after giving birth. The quantifiable data were analyzed by comparing means using ANOVA followed by the Scheffe test.
  
  
  RESULTS
  Women in the 2-hour arm were significantly more satisfied than those in the other two arms (p < 0.001), despite having the most obstetric intervention.
  
  
  CONCLUSIONS
  For women in prolonged labor, obstetric intervention can be an acceptable or even favorable option. Midwives and obstetricians need to provide labor management that takes into account the preferences of the women to whom they give care.
authors.affiliation: Liverpool Women's Hospital, Merseyside, United Kingdom.
authors.forename: T
authors.initials: T
authors.lastname: Lavender
authors.forename: A H
authors.initials: AH
authors.lastname: Wallymahmed
authors.forename: S A
authors.initials: SA
authors.lastname: Walkinshaw
mesh_terms: D000328:Adult; D020070:Cervical Ripening / Q000187:drug effects / Q000502:physiology*; D002585:Cesarean Section / Q000706:statistics & numerical data; D019091:Critical Pathways / Q000592:standards*; D004420:Dystocia / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D009035:Mothers / Q000523:psychology*; D017060:Patient Satisfaction; D010865:Pilot Projects; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors