Short term thinking is a problem in maternity care. It seems to me as though a good five minute Apgar score, or normal cord blood gases, is the primary end point in far too many studies. These things are not inappropriate outcomes to aim for, but they aren’t enough and can end up meaning professionals in clinical practice lose sight of the big picture. As a parent and birthing woman, […]
The thinking that went into the creation of CTG monitoring was itself fundamentally flawed.
Last week I published a post about why I’m not on a guideline writing group. I mentioned that I sometimes provide anonymous gentle suggestions for people who are working on fetal monitoring guidelines about how to make theirs better. You might like to get a copy of the fetal monitoring guideline where you work / where you support women to birth / where you plan to birth and read the […]
From time to time, I get feedback from people who are surprised / disappointed / angry / annoyed that I’m not a member of a guideline writing group taking on fetal monitoring guidelines. It is true – I’m not. It seems like a reasonable thing to expect me to do, right? I’m across the evidence and I often write about what is wrong with existing guidelines. Why would I not […]
What is epistemic trust? Imagine for a moment that computer interpretation of the CTG has become so good that it now significantly outperforms skilled maternity professionals ability to detect impending fetal hypoxia. As a maternity professional, you can’t see what the computer is seeing, because your brain simply lacks the capacity to interpret the trace the same way the computer does. What criteria would need to be met for you […]
The type of fetal monitoring you decide to use can potentially have a big impact on your experience of giving birth, how you give birth, and the health of your baby.
Central fetal monitoring systems are becoming more and more common in maternity services in high-income countries. Once-upon-a-time heart rate and contraction data were printed directly to paper. Increasingly, these data are turned into a digital signal and shown on a computer screen. Digital data are easy to move to a place outside the birth room. With central fetal monitoring, data are moved to a central location in the maternity service, […]
Is it OK to manipulate the information we share with birthing women about fetal monitoring so they do what we want?
Sometimes I spot a new research paper and I ended up thinking – well that was something I never really thought about before! That was what happened when this one came my way. I’m pleased someone thought to do this research and I hope maternity professionals can adopt their practice with these findings in mind. How was it done? The paper has the slightly confusing title of “The effect of […]
Back in 2022 I wrote a book. Or at least, I wrote the first draft of what I plan will become a book. It doesn’t have a proper name yet – it is saved as simply “The CTG Book” on my hard drive. It has sat there, looking a bit sad, ever since I got to the end of the final chapter. It ended up in the “too hard” basket […]
Birth Small Talk 