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.
Reflections
My thoughts and ideas
Is 40 years long enough?
The Dublin randomized controlled trial published in July 1985 aimed to determine the effectiveness of continuous fetal monitoring (CTG) over intermittent auscultation during labor. The trial found no significant differences in outcomes for babies. Despite its findings, CTGs remained widely used. It’s time to do something about that.
Why it’s not ok to say “I don’t do vaginal breech birth”
The post discusses the importance of practitioners being skilled in vaginal breech birth, highlighting the ethical implications of stating, “I don’t do vaginal breech birth.” It emphasizes that women often lack control over their birthing circumstances and need competent care providers to ensure safe delivery, advocating for comprehensive training and skill development in maternity care.
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 While it identifies some correct points about fetal heart rate interpretations, it perpetuates outdated practices and fails to acknowledge the need for consent in monitoring, thus serving more as promotional content than genuine education.
Are we monitoring or not? Language matters.
When is fetal monitoring not fetal monitoring? #EFM #CTG #LanguageMatters
Whose CTG data is it?
There is a lack discussion surrounding the unconsented use of women’s clinical data for CTG analysis training in AI. Women should know when and how their data is being used, and benefit from their data use when corporations profit from it.
The importance of bread and roses too
In 1910, suffragist Helen Todd highlighted the importance of women’s voting rights for improving working conditions, coining the phrase “Bread for all, and Roses too.” While maternity services focus on physical health (Bread), there is a pressing need to enhance women’s emotional and experiential birth outcomes (Roses), fostering joy and meaning in the process.
Concept creep and the CTG
Prevalence-induced concept change is a psychological phenomenon where the meaning of a concept shifts due to declining frequency of related events. Over time, the definition of “high risk” in maternity care has expanded despite reduced perinatal mortality, leading to shifts in CTG usage.
Wrapping up 2024
2024 was a big year for me. And 2025 looks set to be even more amazing! This is what I got up to this year, and what I have planned for the next.
The CTG as a self-fulfilling prophecy
This week I explore flawed beliefs in the effectiveness of fetal monitoring technology through a circular argument. It highlights three steps: assuming success when bad outcomes don’t occur, blaming individuals when they do, and declaring some cases unavoidable. It’s time the research to settle this was done.
Birth Small Talk 