Context: When there is an unplanned or emergency Caesarean Section, the indication and its urgency need to be effectively communicated amongst the team members namely the labour ward staff. The Royal College of Obstetrics & Gynaecology’s National Institute of Health & Clinical Excellence (NICE) has recommended the use of grading of the urgency of Caesarean Section (NICE guideline CG 132, 2011) to minimise the differences in perception. Grading is dependent on the urgency of the Caesarean Section taking into account the danger degree towards the mother and the unborn child.

Objective: To determine if grading of Caesarean Section is being used effectively and documented appropriately within the labour ward team. The documentation must denotes; the indication of Caesarean Section, grade of Caesarean Section, time of decision making, time of knife to skin; and also the decision incision interval (DII) duration.

Design, Setting, Participants: We conducted a single-centred, prospective audit looking into the current labour ward practice. All 277 cases of emergency Caesarean Sections that took place between 1^st March 2016 and 31^st May 2016 were audited in the first cycle. The second cycle of the audit took place from 1^st to 31^st October 2016 whereby 127 cases were analysed to complete the audit cycle loop. A total numbers of 404 cases were reviewed in this audit.

Recommendation: Some recommendations were made to improve the awareness and documentation by having a Training and Awareness Session on Grading of Caesarean Sections, posters, care-flow thinking process using the ‘AIM’ technique with the usage of grading stamps.

Results: A Total number of 404 cases were analysed during this audit. We were able to achieve 100% on documentation on indication of Caesarean Section, timing of decision making and Timing of Knife to Skin, however only 43% (118 cases out of 277 cases) has documented the grade of Caesarean Section. Marked improvement to 95% (121 cases out of 127) on grading documentation was seen after awareness and training inculcated to the labour ward staff.

Conclusion: A complete audit cycle such as this can be used to empower knowledge and can be utilised as a great educational tools. Awareness and team training using ‘AIM technique’ are important to improve performance of the labour ward staff in enhancing effective team work and improved documentation on grades of Caesarean Section. It can also be employed in other emergency situation for the better.