Wrapping up 2024
2024 was a big year for me. And 2025 looks set to be even more amazing! This is what I got up to this year, and what I have planned for the next.
The CTG as a self-fulfilling prophecy
This week I explore flawed beliefs in the effectiveness of fetal monitoring technology through a circular argument. It highlights three steps: assuming success when bad outcomes don’t occur, blaming individuals when they do, and declaring some cases unavoidable. It’s time the research to settle this was done.
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.
Can abnormal heart rate patterns predict outcomes?
A recent review examined the relationship between abnormal heart rate patterns in CTG monitoring and various neonatal outcomes. While some links were identified, particularly with hypoxic ischaemic encephalopathy, overall connections were weak. The evidence suggests CTG monitoring may not be as clinically useful as presumed, prompting calls for alternative monitoring methods.
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.
Are “medical indications” a form of manipulation?
From time to time, I encounter women saying some version of “I’ll only have (insert birth intervention here) if it is medically indicated“. I completely understand the sense in which this is meant – that if something bad is highly likely to happen, and the proposed intervention is highly likely to stop that bad thing happening, then it makes sense to choose the intervention. People use this language as short […]
Myth Busting #3: Fetal monitoring is essential
The third part of a series critiquing common myths about fetal heart rate monitoring. It emphasises that fetal monitoring is not essential for good outcomes, and intermittent auscultation IS fetal monitoring.
Myth Busting #2: CTG misinterpretation harms babies
Does CTG misinterpretation harm babies? Or is something else going on?
Does CTG monitoring work for women with risk factors?
Today’s post shares the back story behind our paper. #CTG #EFM #PerinatalMortality #CP
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Birth Small Talk 