Table 6 Seven target areas for improving intrapartum quality of care at the study site

1. Strengthened risk assessment on admission, with particular focus on foetal heart rate, blood pressure, temperature, and previous obstetric history.

2. Improved routine surveillance during latent and active phase of labour, regarding all key parameters (foetal heart rate, dilatation of cervix and descent, contractions, maternal vital signs, and urinary output).

3. Increased prioritization of women with already diagnosed intrauterine foetal death for routine assessments during labour.

4. Timely prevention and management of prolonged labour, with focus on alternative and less harmful interventions than oxytocin infusion for labour augmentation (e.g. artificial rupture of membranes and emptying of bladder), and more restrictive dosages and improved surveillance when oxytocin is administered.

5. Reduction of caesarean sections after intrauterine foetal death, by improved management of prolonged labour, and enforcement of vacuum extraction and craniotomy use.

6. Improved management of severe hypertensive disorders, with particular focus on antihypertensive treatment.

7. Better intrapartum documentation as well as record keeping.