Quality of Intrapartum Care Documentation at Public Maternity Facilities in Cross River State

Accurate intrapartum care documentation is fundamental to safe obstetric practice, clinical communication, medico-legal accountability, and audit-based quality improvement, yet documentation standards at Nigerian public maternity facilities are inconsistently maintained. This study assesses the quality of intrapartum care documentation at public maternity facilities in Cross River State, South South Nigeria. A retrospective documentation audit of 240 intrapartum case records from 10 public maternity facilities in Calabar, Ikom, and Ogoja LGAs was conducted. A validated documentation audit tool measured completeness of maternal vital signs recording, partograph use, documented interventions, consent documentation, and outcome recording. Overall documentation completeness averaged 58 percent across facilities. Maternal vital signs were recorded at the recommended frequency in only 44 percent of audited records. Partograph completion was below 40 percent in rural facilities. Informed consent documentation for operative procedures was absent in 31 percent of relevant cases. Neonatal APGAR scores were undocumented in 22 percent of birth records. Urban government hospitals consistently outperformed rural facilities on all documentation metrics. Professional recommendations include standardised intrapartum documentation training, designated documentation mentors in each facility, documentation quality inclusion in annual facility performance reviews, and monthly record audits facilitated by Cross River State Ministry of Health quality assurance officers. Keywords: intrapartum documentation, quality of care, Cross River State, maternity audit, record keeping