Bernitz S, et al. - Researchers performed a multicentre, cluster-randomised controlled trial at obstetric units in Norway to study whether the frequency of intrapartum caesarean section (ICS) use differed when adhering to the WHO partograph vs Zhang's guideline for labour progression. Each site was required to deliver more than 500 fetuses per year in order to qualify for inclusion. Study participants included nulliparous women who had a singleton, full-term fetus with cephalic presentation, and who entered spontaneous active labour. No significant difference was found in the frequency of ICS use between the obstetric units assigned to adhere to the WHO partograph and those assigned to adhere to Zhang's guideline. The overall reduction in the use of ICS that they observed in relation to the previous frequency of ICS use observed in these obstetric units could be explained by the close focus on evaluating the progress of labour, rather than using the guidelines. No maternal or neonatal deaths were identified during the study. The outcomes play an important role in the discussion on the implementation of the new guideline.