Birth Small Talk

Fetal monitoring information you can trust

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.

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When research doesn’t go as planned…

In a trial comparing fetal blood sampling to digital fetal scalp stimulation for assessing fetal wellbeing, recruitment fell short, concluding early after just 534 participants. Despite showing a significantly lower caesarean section rate with scalp stimulation, the small sample limits the findings. The irony of guidelines undermining evidence development is discussed.

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Safety and the CTG

A comprehensive literature review by researchers in the UK examined the safety of CTG monitoring in maternity care, identifying prominent system-level issues, including unsafe organizational cultures and inadequate staffing. It is import to focus on staffing, supportive environments, and respectful care to improve outcomes rather than unproven practices.

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Fetal monitoring and choice

Informed consent is a critical principle in healthcare. A recent Australian survey revealed that many women lacked sufficient information and choice about fetal monitoring methods. Only 35% reported being asked for consent. This highlights a significant issue in maternity care, and it is well past time it was addressed.

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Inventing the CTG

The development of the cardiotocograph (CTG) in obstetrics evolved from earlier fetal monitoring methods over a century. While intended to enhance fetal safety, its integration shifted focus towards legal liability and technology reliance, often undermining maternal care. Concerns about research integrity and the effectiveness of CTGs suggest the need to reassess their use in maternity care.

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