Maternity & Labor and Delivery (L&D) SBAR Template
Designed for obstetric triage, labor and delivery handoffs, postpartum maternal deterioration, and perinatal emergency escalation. Built around dual-patient evaluation (mother and fetus) and standardized NICHD fetal monitoring criteria.
Why Obstetric & Perinatal SBAR Communication Differs
Perinatal nursing is unique because every clinical interaction involves at least two patients: the mother and the fetus. Communication must capture rapid obstetric dynamics and standardized nomenclature:
Maternity & L&D SBAR Clinical Worksheet (Blank)
Standardized layout for labor handoffs, obstetric provider alerts, and fetal tracing escalations.
Identify primary acute concern: Category II/III fetal tracing, severe range hypertension, postpartum hemorrhage, cord prolapse, or rapid labor progression.
• Primary Concern: [ ] Fetal Heart Rate Deterioration [ ] Severe Pre-Eclampsia [ ] Hemorrhage / QBL [ ] Labor Arrest [ ] Cord Prolapse
• Current Stage of Labor: [ ] Triage [ ] Stage 1 (Latent/Active) [ ] Stage 2 (Pushing) [ ] Stage 3/Postpartum
• Urgency Level: [ ] Emergent (immediate bedside) [ ] Urgent (within 15 min) [ ] Informational/Orders
Prenatal risk factors, GBS status, membrane status (ROM), anesthesia/analgesia, current infusions, and allergies.
• Obstetric History & Comorbidities: GBS: [ ] Pos [ ] Neg [ ] Unk | Rh: [ ] Pos [ ] Neg | [ ] Prior C/S [ ] GDM [ ] Chronic HTN
• Membranes: [ ] Intact [ ] SROM / AROM at (time): _________ | Fluid: [ ] Clear [ ] Meconium (light/thick) [ ] Bloody
• Active Infusions / Meds: Oxytocin: _____ mU/min | Magnesium Sulfate: _____ g/hr | Epidural: [ ] Yes [ ] None
• Allergies: ____________________________________________________________________________________
FHR baseline, variability, decelerations, NICHD category, uterine activity, cervical exam, and maternal vital signs.
• Fetal Heart Rate (FHR): Baseline: _____ bpm | Variability: [ ] Mod [ ] Min [ ] Absent | Decels: [ ] None [ ] Early [ ] Variable [ ] Late [ ] Prolonged
• NICHD Fetal Tracing Category: [ ] Category I (Normal) [ ] Category II (Indeterminate) [ ] Category III (Abnormal)
• Contraction Pattern: Frequency: every ____ min | Duration: ____ sec | Resting tone: [ ] Soft [ ] Hypertonic / Tachysystole
• Cervical Exam: Dilation: _____ cm | Effacement: _____% | Station: _____ | Presenting part: [ ] Vertex [ ] Breech
• Maternal Vitals: BP: _____/_____ | HR: _____ | Temp: _____°F | SpO2: _____% | Pain: _____/10 | Bleeding / QBL: _____ mL
• Intrauterine Resuscitation Initiated: [ ] Reposition (left/right lateral) [ ] IV fluid bolus [ ] O2 applied [ ] Oxytocin stopped [ ] Terbutaline given
Specific request for bedside physician exam, IUPC/FSE placement, amnioinfusion, stat antihypertensive, or emergency operative delivery.
• Requested Action: [ ] Immediate bedside physician evaluation [ ] Place FSE / IUPC [ ] Emergency C-Section / Operative Delivery [ ] Antihypertensive Order
• Specific Medication / Order: __________________________________________________________________
• NICU / Anesthesia Alerted: [ ] Yes [ ] Pending confirmation
Maternity Escalation Example: Category II Fetal Tracing & Tachysystole
Scenario: A 28-year-old Primigravida at 39 weeks 2 days gestation in active labor on Oxytocin induction develops uterine tachysystole with recurrent late decelerations and minimal variability.
"Dr. Patel, this is Jessica, RN in L&D Room 4 calling regarding patient Maya T., a 28-year-old G1P0 at 39 weeks 2 days. The fetal heart rate tracing has deteriorated to Category II with recurrent late decelerations and minimal variability following uterine tachysystole over the last 15 minutes."
"She was admitted this morning for elective induction of labor. GBS negative, Rh positive, uncomplicated prenatal course. AROM was performed 3 hours ago with clear amniotic fluid. She has a functioning labor epidural with good pain control. She was on Oxytocin at 12 mU/min. No known drug allergies."
"The fetal heart rate baseline is 145 bpm with minimal variability (less than 5 bpm) and recurrent late decelerations dropping to 105 bpm lasting 45 seconds after each contraction. The toco showed tachysystole with 6 contractions in a 10-minute window. Cervical exam 10 minutes ago was 6 cm dilation, 80% effacement, -1 station. Intrauterine resuscitation interventions completed: Oxytocin infusion turned completely off, repositioned patient to left lateral position, administered 500 mL IV Lactated Ringer's bolus, and applied non-rebreather mask at 10 L/min. Maternal vitals: BP 118/74, HR 82 bpm, Temp 98.6°F, SpO2 99%."
"I request that you come to the bedside to evaluate the fetal tracing. If the decelerations persist despite turning off Oxytocin and position changes, I recommend an order for Terbutaline 0.25 mg SQ for tocolysis, and placing a Fetal Scalp Electrode (FSE) and Intrauterine Pressure Catheter (IUPC) for direct monitoring."
Available SBAR Formats
Choose the format that fits your clinical workflow or educational setting.
Authoritative Obstetric & Perinatal Sources
- •American College of Obstetricians and Gynecologists (ACOG): Practice Bulletin No. 106 – Intrapartum Fetal Heart Rate Monitoring & NICHD Three-Tier Classification.
- •Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN): Standards for Professional Nursing Practice in the Care of Women and Newborns.
- •The Joint Commission (TJC): Sentinel Event Alert – Preventing Maternal Death and Morbidity through Standardized Obstetric Communication.