Toolbox: Promoting Progress in Labor

Resources and Tools

To show the list of resources and tools available within each category, click "Click to Expand" under the category subhead. Click on the icon to the left of the resource you wish to download or, in the case of a weblink, be taken to. You can also search our entire library of resources and tools by keyword, category or topic by going to our "Browse All' page


DocumentsLabor Progress Chart
This chart is a a nursing tool to guide assessment related to labor progress.

DocumentsLabor Progress Form
This form is a tool to guide assessment and appropriate interventions related to labor progress.

Audit Tools

DocumentsFirst Stage of Labor Audit Tool
Measure and track your progress using evidence-based process and outcome measures with this audit tool.


DocumentsPromoting Labor Progress Bundle
The Promoting Labor Progress Bundle is a resource developed by ACNM for the Reducing Primary Cesarean Project. This bundle aims to support evidence based measures to promote spontaneous labor progress, including newer definitions of duration, to reduce unnecessary cesarean.

Clinical Education/Staff Training Resources

DocumentsPartograph for Low-risk Nulliparous Women in Spontaneous Labor

Improvement Stories

LinkReducing Primary Cesarean Births Collaborative Success Story
The team at Winthrop Hospital utilized the Promoting Spontaneous Progress in Labor bundle as a part of the Reducing Primary Cesareans (RPC) Collaborative.

LinkReducing Primary Cesarean Births Initiative Success Story
As a part of the Reducing Primary Cesareans (RPC) Collaborative, the team at the University of Minnesota Medical Center & University of Minnesota Masonic Children’s Hospital and successfully decreased their primary cesarean rate by over 10% in one year.

LinkIdentification and Manual Rotation of the Occiput Posterior Fetus
Oregon Health and Science University (OHSU) introduces manual rotation of the occiput posterior fetus to improve vaginal birth rates and decrease complications related to persistent OP position.

Model Policies

DocumentsManagement of Labor Progress-UNM
This guideline is to facilitate the standardized active management of all stages of labor to balance the reduction of c-section rates while minimizing the complications of prolonged labors. Developed by UNM.

LinkBest Practice Guidelines: Transfer from Planned Home Birth to Hospital
This PDF download features guidelines that were developed by a multidisciplinary group of home and hospital based providers and stakeholders who were delegates at the national Home Birth Consensus Summits in 2011 and 2013. These guidelines are informed by the best available evidence on risk reduction and quality improvement.

LinkChanging Hospital “Visiting” Policies and Practices: Supporting Family Presence and Participation
Link to PDF download. This document provides guidance and a policy template for supporting unlimited access to family members, including children, during a hospital stay, developed by the Institute for Patient- and Family-Centered Care.

DocumentsLatent Phase of Labor Policy
This policy is used in a busy hospital setting to support physiologic approaches to care of women who come to the hospital during latent phase labor. Provided by Calgary Health Region.

DocumentsFetal Health Surveillance Policy
This policy is used in a busy hospital setting to support physiologic approaches to care of women who come to the hospital during latent phase labor. Provided by Alberta Health Services.

Patient Education/Shared Decision Making

DocumentsOptimal Positions Labor Guide
Explanations of different positions for a laboring mother to promote comfort and aid in progress of labor and delivery. Specifically highlighting physiologic labor/pre-epidural, epidural/laboring down, and malpositioned baby issues. Includes example photos.

DocumentsChoosing Your Positions During Labour and Birth
This document offers decision making aids for women regarding options for positions during labor and birth.

Position Statements/Related Guidelines/Toolkits

DocumentsLabor Duration Management Guideline
This document is a comprehensive review of management options for labor duration challenges and promotion of labor progress. Developed by the Zuckerberg San Francisco General Hospital (ZSFG) in 2015.

Photo ©2011 and provided courtesy of the
American Academy of Nursing, SternerTurner Media


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