Is it time to rethink the concept of “fetal distress”?
The design of the very first RCT about CTG monitoring is interesting, and it raised a question which we really haven’t ever answered fully. Does the use of CTGs create the very problem they are meant to prevent?
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 intrapartum CTG monitoring. The authors pointed out that: Despite evidence-based guidelines from professional associations recommending IA, and warning against the use of continuous monitoring, healthy individuals in labour are rarely monitored intermittently. The harms of routine EFM use are well established, yet it continues […]
Most high-income countries require maternity clinicians who work with women during labour to attend regular courses on the use and interpretation of CTG monitoring. I’ve been to more than a few during my time – but I have never been to an education session where there was a specific focus on how to use and interpret IA.
Does teaching women to focus on the movements of the fetus prevent stillbirth, or does it create a new set of problems?
The history of maternity care is essentially the story of men trying to make sense of women as a mysterious “other” to men. This is true of the history of fetal heart rate monitoring too.
I quite like Doctor Who. One of the common threads in the show involves the Doctor warning their companions that it is important not to meddle with the past in a way that might alter the future. Of course, what inevitably happens is that the Doctor and companions end up being compelled take action in order to ensure that everyone arrives at the end of the episode happy and healthy, […]