Why might midwives not support women’s choices?
The problem with guidelines is not that they exist nor that they play a role in structuring good practice. The problem is when guidelines over-reach their purpose.
CTG
Cardiotocograph monitoring
Who makes decisions about fetal heart rate monitoring and how does it happen?
Myself and my co-authors have a new paper, freshly published with Women and Birth (available here). One of the questions I asked while generating data from my doctoral research was – who made the decision about the approach to fetal heart rate monitoring that any individual woman would use during her labour? At first glance, the answer seemed to be that no one was actively making decisions. I didn’t interview […]
It seems we can’t agree on this one….
Whose fault is it when we can’t agree on the CTG? #EFM #CTG #CTGInterpretation #CentralFetalMonitoring
What we don’t know about lactate might be harmful
We really have no idea what we are doing when it comes to fetal blood sampling during labour. Maybe we should stop doing it.
When the CTG is not normal, should you turn on STAN or check the fetal pH?
CTG monitoring is in use during a woman’s labour. The fetal heart rate pattern is now abnormal. As her maternity professional, you know that the positive predictive value of the CTG is low, and want to avoid caesarean section unless it is going to improve the fetal outcome. And you don’t want to misidentify when caesarean section is a great idea and as a result have an avoidable poor outcome […]
Is that what it really says? When professional guidelines get creative with truth.
We expect that evidence based guidelines are written by people who can critically review and use evidence. Sometimes that’s not what happens though. Here’s an example….
EEG for intrapartum fetal monitoring
Can you record an EEG signal with a fetal spiral electrode? And why might you want to?
Models of maternity care and conversations about fetal monitoring
How are we doing when it comes to talking to women about fetal monitoring options and respecting their decisions? #InformedChoice #SharedDecisionMaking #MidwiferyContinuityOfCare #RespectfulMaternityCare
What is a medical indication?
Medical indications exist somewhere on a spectrum between being written on tablets of stone, handed down to new doctors by a supreme being on a mountain top – to being completely made up on a whim. What happens when they are misused?
Adding something extra to make the CTG work
Can we get CTG monitoring to improve outcomes by adding extra bits to it? A summary of what I have previously written.
Birth Small Talk 