Birth Small Talk

Fetal monitoring information you can trust

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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When is CTG use in labour a good idea?

Fetal monitoring guidelines around the world recommend CTG use in labour when women are considered to be a higher risk for a bad outcome for the baby that is linked to low oxygen levels in labour. Regular readers of my blog will have seen me write repeatedly about the lack of great evidence to back this up. There’s no compelling research showing better outcomes with CTG use for women planning […]

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Water birth and the perineum: Part 1

The past decade has seen quite a lot written about whether giving birth in water is good or bad for women’s perineums. The UK seems to have been the hotspot for these discussions. In today’s blog post, I’m going summarise a new piece of research that has kicked off another round of letters to the editor. How was the research done? This new, just published trial is the POOL cohort […]

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Are midwives accurate? The AAT Part 2.

Last week I explained what the AAT was. This week I want to share research that compared one midwife against another, to see if they were able to generate an accurate assessment of the fetal heart rate pattern, and were able to detect accelerations as reliably as a CTG machine. If you missed last week’s post and don’t know what I’m talking about – you can find it here. How […]

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What is the Auscultated Acceleration Test?

With thanks to Maryann Long, CNM, PhD, for bringing Lisa Paine’s work to my attention. I’m always fascinated about how some new ideas “stick” and are incorporated into practice, while others fall by the wayside. Despite having read widely about fetal heart rate monitoring options for the past decade, the Auscultated Acceleration Test never crossed my path. This simple approach seems to have fallen by the wayside. I want to […]

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Words have power

Words have power. I know this – the approach I used for my doctoral research requires you to look closely at how language shapes the social world. If you have hung around the birth world for a bit, you have probably made some conscious choices about whether you use the words “patient” and “delivery”. I spend most of my working week choosing which words work best to get the job […]

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