Birth Small Talk

Fetal monitoring information you can trust

Who is in the centre?

Central fetal monitoring systems gather data from CTG machines and show it in a central place. While aimed at improving outcomes this has not been proven in research. Midwives reported disruptions in response to what was seen at the central monitor, leading to altered care practices focused on documentation over support for birthing women. It is time to pause and think, rather than continue to accept the introduction of these systems.

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Humans are still better than computers

A Japanese research team compared human and artificial intelligence performance in analyzing CTG data to predict perinatal asphyxia. Clinicians slightly outperformed AI in accurately diagnosing affected babies. However, limitations raise concerns, emphasising the essential role of healthcare professionals over machines in maternity services.

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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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