Birth Small Talk

Fetal monitoring information you can trust

Obstetrics

Leave a comment

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?

Continue Reading →

20 Comments

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 […]

Continue Reading →

2 Comments

Is teaching keeping up with evidence?

The article reviews a recent paper on fetal monitoring during labor by Richmond et al. which lacks a reference list, undermining its educational value. While it identifies some correct points about fetal heart rate interpretations, it perpetuates outdated practices and fails to acknowledge the need for consent in monitoring, thus serving more as promotional content than genuine education.

Continue Reading →

1 Comment

Inventing the CTG

The development of the cardiotocograph (CTG) in obstetrics evolved from earlier fetal monitoring methods over a century. While intended to enhance fetal safety, its integration shifted focus towards legal liability and technology reliance, often undermining maternal care. Concerns about research integrity and the effectiveness of CTGs suggest the need to reassess their use in maternity care.

Continue Reading →

1 Comment

Water birth and the perineum – what is all the fuss about? Part 3

This week I’m returning to an exploration of the literature about water birth and the perineum. The recently published paper by Sanders and colleagues (2024, in press) has already generated two letters to the editor. I want to start by looking at their criticisms and considering their validity, before making some conclusions about what I think the POOL study can teach us. Letter number 1 The first of the letters […]

Continue Reading →

4 Comments

Water birth and the perineum: Part 2

As I was pondering on the question of why water birth seems to get obstetricians in a bit of a tizzy – I realised my own experience of learning to support women at water births provides some clues. This week’s post is a reflection on what I have learned as an obstetrician who has been present at over 100 water births. The early days While I had been interested in […]

Continue Reading →

Leave a comment

Words have power

Words have power. I know this – the approach I used for my doctoral research requires you to look closely at how language shapes the social world. If you have hung around the birth world for a bit, you have probably made some conscious choices about whether you use the words “patient” and “delivery”. I spend most of my working week choosing which words work best to get the job […]

Continue Reading →