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 […]
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 […]
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.
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, […]
Is it OK to manipulate the information we share with birthing women about fetal monitoring so they do what we want?
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 […]
Back in 2022 I wrote a book. Or at least, I wrote the first draft of what I plan will become a book. It doesn’t have a proper name yet – it is saved as simply “The CTG Book” on my hard drive. It has sat there, looking a bit sad, ever since I got to the end of the final chapter. It ended up in the “too hard” basket […]
I wrote this post back in February 2020 when this research was new. It’s a paper I often reference and use in my presentations. I’ve refreshed the post and am sharing it again because I think it contains valuable information. Research published this week by Chuey, De Vries, Dal Cin, and Low (2020) explored facilitators and barriers to the use of intermittent auscultation (IA) rather than CTG monitoring during labour. […]
Last week I shared two different research papers highlighting a link between epidural use and caesarean section for abnormal fetal heart rate patterns, pointing out that how these things were connected was not explained by this research. An independent group of researchers, based in Italy, have also recently published research in this area, and their findings provide some additional clues about what might be going on (Ghidini et al., 2023). […]
One of the problems I see with the evidence base relating to fetal heart rate monitoring during labour, is the focus predominantly on the immediate outcomes of birth. This is really obvious when you look at outcomes for the woman. The studies included in the Alfirevic et al., 2017 Cochrane review report on how women gave birth (caesarean section, instrumental birth, or spontaneous vaginal birth), whether they made use of […]
Birth Small Talk 