Add central fetal monitoring and stir: Is this the solution to understaffing?
What happens when you introduce a central fetal monitoring system into a maternity service who are struggling to provide adequate staffing to maintain safety?
EFM
Electronic fetal monitoring
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 […]
Is more technology the solution to fetal monitoring?
The thinking that went into the creation of CTG monitoring was itself fundamentally flawed.
What would a good fetal monitoring policy look like?
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 […]
Why I’m not on a guideline writing group
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 […]
Would you trust a computer to decide when to do a caesarean section?
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 […]
Five questions to ask yourself when deciding about fetal monitoring in labour
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.
Five questions you should ask about central fetal monitoring
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, […]
Let’s just pop you on a trace. A reflection on language.
Is it OK to manipulate the information we share with birthing women about fetal monitoring so they do what we want?
Loud CTGs – turn it off!
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 […]
Birth Small Talk 