Birth Small Talk

Fetal monitoring information you can trust

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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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 […]

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Dawes Redman system

A student in my Fetal Monitoring for Maternity Professionals course asked me about this recently – and I realised I had never written about it, despite having promised to do so a few times! This is for Natalie, with gratitude. What is the Dawes Redman system? As an Australia maternity care provider, I have never encountered the Dawes Redman system in clinical practice. Its use seems to be widespread in […]

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Water birth and the perineum: Part 4

The POOL study (more information is here if you haven’t been following along with this series) is simply the latest in a long series of studies examining aspects of safety relating to the use, or not, of water immersion at birth. Where does the POOL study evidence fit with what was already known from earlier research? Does it provide something new and controversial, or does it reinforce where the evidence […]

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Water birth and the perineum – what is all the fuss about? Part 3

This week I’m returning to an exploration of the literature about water birth and the perineum. The recently published paper by Sanders and colleagues (2024, in press) has already generated two letters to the editor. I want to start by looking at their criticisms and considering their validity, before making some conclusions about what I think the POOL study can teach us. Letter number 1 The first of the letters […]

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Water birth and the perineum: Part 2

As I was pondering on the question of why water birth seems to get obstetricians in a bit of a tizzy – I realised my own experience of learning to support women at water births provides some clues. This week’s post is a reflection on what I have learned as an obstetrician who has been present at over 100 water births. The early days While I had been interested in […]

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