What’s wrong with central fetal monitoring?
Central fetal monitoring is sneaking its way in pretty much everywhere. Lots of people love it. Here are some of the reasons I have serious concerns about it…
Reflections
My thoughts and ideas
The emotional costs of moving away from CTG use
Maternity professionals often find comfort, competence, and control in CTG monitoring. Transitioning to intermittent auscultation requires that we address these emotional attachments. My suggestions on how to achieve this are in this week’s blog.
There’s an invisible human rights issue in maternity care – let’s talk about it
It’s time to highlight the serious issue of unconsented fetal monitoring during childbirth, and the widespread misinformation about its safety and efficacy. It’s time to fix the underlying causes – starting with how guidelines are applied in practice.
How the RANZCOG policy changed
Analysis of the RANZCOG Intrapartum Fetal Surveillance guideline reveals significant changes between the 3rd and 5th editions. Key improvements include clear responsibility shifts to clinicians, realistic evidence levels for CTG use, and better evidence organization regarding risk factors.
I’m 41 weeks pregnant. What’s the deal with CTG monitoring?
RANZCOG’s fifth edition guideline highlights prolonged pregnancy (over 41 weeks) as a risk factor for intrapartum fetal compromise. Low-grade evidence suggests a slight increase in the risk of brain injury for babies born after 41 weeks. The guideline sets out professional’s responsibilities to support women to make their own decisions about fetal monitoring methods.
Why artificial intelligence systems for fetal monitoring are so seductive to healthcare systems (and why that is a huge ethical problem)
Fetal heart rate monitoring traditionally involves professionals interpreting patterns, but technology has introduced complex, expensive systems aimed at improving outcomes. Despite this, there are ethical concerns regarding women’s consent and data use. The focus appears to prioritize cost reduction for healthcare systems over meaningful enhancements in maternal and fetal care outcomes.
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.
Three things to stop saying about fetal monitoring
Terms like “happy,” “tired,” and “distressed”have no place in fetal monitoring discussions. Let’s use accurate language to describe fetal health, instead of emotional interpretations.
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