OBJECTICVE : To explore and describe the use of the partogram in private hospitals in South Africa. DESIGN : An explanatory mixed method design. In-depth interviews were conducted with the midwives and midwife specialists to explicate the significance of the initial quantitative questionnaires. SETTING : A private maternity hospital in Gauteng Province, South Africa. PARTICIPANTS : 11 midwives and 3 advanced midwives working in the labour unit of the private maternity hospital. FINDINGS : Although all the midwives and midwife specialists knew the purpose of the partogram, where to find the recommendations on the use of the partogram and the signs of true labour, not all were sure when the partogram had to be completed and who is accountable for plotting the findings. Fetal heart rate monitoring during the active phase of labour remains a concern. KEY CONCLUSION : The findings revealed that the midwives understood the importance of the partogram but are not using it within the parameters for which it was intended. The obstetricians intervened during labour with no or little use of the partogram. IMPLICATIONS FOR PRACTICE : The study identified the knowledge strengths and deficits of midwives working in a private hospital on partogram use that would benefit from training interventions and professional development. Evidence suggests a culture where the partogram is not central to care as obstetricians are not using the partogram. The purpose of the partogram in the private sector needs to be reviewed.