Thanks 2025 – and now on to 2026!
In 2025, I published 46 blog posts attracted 26,800 readers, and had over a million views on Facebook. I have big plans for 2026 – read on to find out more. Subscribe so you don’t miss out on any of the new things!
EFM
Electronic fetal monitoring
There’s a new RANZCOG fetal monitoring policy: What do they get right and what do they get wrong?
The recent fifth edition of RANZCOG’s fetal monitoring guideline adopts a new approach, providing more accurate summaries of the quality of their evidence. Although it emphasises women’s autonomy, they have not quite completed the task of shifting decision-making from obstetricians.
Australian folks – are you interested in joining me in a workshop in the new year for a detailed look at how to apply the guideline to your practice?
Should fetal blood sampling become a thing of the past?
Fetal blood sampling (FBS) has a long history but faces ongoing debates about its relevance. Current evidence shows poor predictive capabilities, and the reliability of fetal blood lactate testing remains disputed. FBS is another example of a fetal monitoring technology that lacks a firm evidence base.
Does CTG monitoring education actually work?
The introduction of the Fetal Surveillance Education Program (FSEP) has been claimed to improve neonatal outcomes. However, the raw data suggests otherwise. A comprehensive literature review indicates inconsistent evidence for CTG training benefits. CTG education should not be mandatory!
Digital fetal monitoring and ethics
I have lived through the rapid evolution of digital technologies. While digital tools offer new possibilities, they also raise ethical concerns, particularly with fetal monitoring. We need to talk about the ethics of digital fetal monitoring more than we currently are.
Why bother?
If you have been hanging around Birth Small Talk for more than a moment, you’ll know I’m very focussed on putting the evidence about fetal heart rate monitoring in front of as many people as possible. And you’ll know that this position puts me at odds with a lot of what most people will hear in mainstream maternity services. So I get some pushback from time to time. And even […]
Human rights and artificial intelligence in healthcare
Recent publications on fetal monitoring highlight the rise of artificial intelligence (AI) in interpreting CTG recordings. While advancements promise decision-support systems, rights issues remain. Ploug and colleagues emphasize the need for regulations in AI-driven healthcare to protect people’s rights, urging the integration of these considerations into technology development from the outset.
Are all fetuses the same?
In the past two decades, standardized approaches to cardiotocography (CTG) interpretation have evolved. They don’t take into account that specific fetal heart rate patterns may vary by fetal sex and age. There is a need for individualised interpretation as standard guidelines may not account for all fetal characteristics, potentially leading to misinterpretation and harm.
Does CTG monitoring during labour save lives?
The evidence on CTG monitoring vs intermittent auscultation during labour does NOT prove that CTG significantly reduces stillbirth or neonatal mortality rates, in either low or high-risk populations. Professionals and academics MUST avoid misleading people about the evidence.
Should we be using amnioinfusion?
Amnioinfusion is a procedure that delivers fluid into the uterus, aimed at improving fetal outcomes during labor, particularly when decelerations occur. A recent study found a significant reduction in total deceleration area post-amnioinfusion but lacked a control group. Caution is advised before widespread adoption of this practice.
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