Birth Small Talk

Fetal monitoring information you can trust

CTG

Cardiotocograph monitoring

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Tending to the machine: Women’s experiences of fetal monitoring in labour

Last week I posted about a literature review that summarised 47 years of research about women’s experiences of labour. The same research team responsible for that paper, has also just recently published new Australian research (Fox et al., 2024) describing women’s current experiences with fetal monitoring in labour. The paper has been published in an open access journal, so you are able to read the full paper yourself. If you […]

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What is CTG monitoring like?

Much of the focus in research about fetal monitoring in labour has been on outcomes for the fetus / baby. Not as much has looked at women’s outcomes, and even less has looked at what women say about their experiences with CTG monitoring. But there has been some research, and a team of researchers recently pulled it all together in the one place (Murray et al., 2024). Murray and colleagues […]

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Reducing anxiety during antenatal CTG monitoring

CTG monitoring during pregnancy is called non-stress testing in some parts of the world. This is to distinguish it from stress testing, where low doses of oxytocin or nipple stimulation are used to provoke contractions so the way the fetal heart rate responds to contractions can be observed. The term non-stress testing is rather ironic however, as there is a body of evidence showing higher levels of anxiety in women […]

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Education isn’t the solution

When there’s a string of poor outcomes in a maternity service, and issues around fetal heart rate monitoring in labour are found to part of the problem, what invariably happens next is a recommendation for more and better education. It seems logical to believe that people who know more about the indications for CTG monitoring, how to interpret fetal heart rate patterns, and how and when to intervene in labour […]

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Do people agree on antenatal CTGs?

There has been a lot of research about whether health professionals agree on what to call the pattern on a CTG during labour. And the experts all agree, that the experts don’t agree. That is to say, there is a troubling degree of variability in how maternity professionals interpret the same CTG pattern. This is something I have written about before (here, here, and here). Until recently, I had never […]

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Maternal heart rate recording to improve outcomes

Many things related to fetal monitoring in labour have been introduced because they seemed like a good idea, but never properly evaluated to determine whether they work (like “Fresh Eyes” checks, and central fetal monitoring). There is increasing recognition that one of the reasons for poor outcomes when CTG monitoring is used is not realising the heart rate being recorded is that of the woman and not her fetus. Many […]

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Caesarean section and stillbirth risk

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, […]

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