Overdiagnosis and CTG monitoring
Unlike Dr Who, we can’t drop into our future timeline to see what the consequences of our current decisions are. If we could, would we make different choices?
Oxygen levels and lying on your back when pregnant
Going to sleep lying flat on the back (supine position) has been linked to a higher rate of stillbirth between 28 weeks of pregnancy and the start of labour, with the chance rising closer to the end of pregnancy (McCowan, et al., 2017). Because of this, many countries now issue public recommendations about going to sleep in a side lying position in late pregnancy. The McCowan study also showed a […]
Barbie’s friend Midge: What does she tell us about feminism?
I’ve only just recently been to see the Barbie movie. It was fun, pink, sparkly, with a beautifully realised portrayal of Barbie Land, and excellent music. My daughter and I watched it in a middle of the day, middle of the week sitting and had the luxury of having the entire cinema to ourselves with the exception of one other woman. Very handy when you might end up singing along! […]
Gestational diabetes and the best time to give birth
There’s a fair bit of controversy about whether, how, and when to test for diabetes in pregnancy. This post focusses on one decision women with a diagnosis of diabetes are often asked to make – when to give birth. (If you are after information about other aspects of diabetes in pregnancy, Rachel Reed and Sara Wickham both have great blogs about this, and both have books on induction of labour.) […]
Doctor Who and changing the future
Don’t change the future! I quite like watching Doctor Who. One of the common threads in the show involves the Doctor warning their companions not to meddle with the present (our past) in a way that might alter the future (our present). Of course, what inevitably happens is the Doctor and companions end up being compelled take action to ensure that everyone arrives at the end of the episode happy […]
Reviewing the evidence for Intermittent Auscultation
I was excited to see a new paper, setting out the evidence for intermittent auscultation in labour (Anderson, et al., 2023). It was published in a journal for US based nurse-midwives, so it relates to the context of care in that country. Let’s see how they did in terms of getting the facts right. Is their evidence accurate? They wrote that: All this is correct, except that one of the […]
Perineal trauma prevention: achieving less while doing more
In a slight departure from normal programming, I’m tackling perineal trauma today. This is a topic I have posted about before (like this, this, and this), and have contributed to research in this area (Allen, Small, & Lee, 2022). A bit of background In the birth-world, the term perineum is generally used to mean the area between the back of the vagina and in front of the anus (back passage). […]
Hypoxic ischaemic encephalopathy prevention: is it working?
Hypoxic ischaemic encephalopathy (or HIE) is a condition affecting newborn infants. As the name suggests, it relates to low oxygen supply (hypoxia), and / or reduced blood flow (ischaemia) causing damage (-pathy) to the brain (encephalo-). Other parts of the body might also show signs of damage from low oxygen, like the kidneys or the gut. It is diagnosed when there is a combination of high acid levels in umbilical […]
Plans, preferences, maps: Getting the birth you want
I have a love-hate relationship with birth plans (by any name). Progressive standardisation of care means a woman entering maternity care systems risk being swept along with the current, her body being used to meet the organisation’s goals and priorities, not her own. Women who dare to hope for something different might be told they have “unrealistic expectations of the control they will have over the experience”, as the New […]
Antenatal CTGs in the Netherlands: the impact on midwifery continuity of care
While last week’s post questioned whether we should be doing antenatal CTGs at all, this week’s post explores the positive impact of a shift from referring women into obstetric care for antenatal CTG monitoring to providing this in primary midwife-led care. Maternity care in the Netherlands The Netherlands offers a very different approach to maternity care than most other high income countries. Midwifery care is very much accepted and supported […]
Birth Small Talk 