In 2023, Australia recorded 218,099 births, with a rising cesarean section rate, now exceeding 40%. Induction rates and maternal age increased, while the perinatal mortality rate also rose to 11.0 per 1,000. Despite efforts to enhance birth safety, outcomes show concerning trends, necessitating reconsideration of the high rates of intervention.
A recent Australian study investigated women’s experiences with various fetal monitoring methods during labor, finding that wired CTG was predominant. First-time mothers reported more CTG use, which correlated with higher emergency cesarean rates and epidural use. Many women felt monitoring negatively impacted their experiences, highlighting a need for improved woman-centered maternity care practices.
CTG monitoring during vaginal birth after caesarean section (VBAC) is often deemed essential, but evidence suggests it does not prevent uterine rupture. Abnormal fetal heart rate patterns indicating rupture can also occur for other reasons. Therefore, CTG is not mandatory; women should choose their monitoring method based on individual circumstances.
Women planning a vaginal birth after cesarean (VBAC) often seek to avoid negative experiences with CTG monitoring. This new mini-course offers reliable information on fetal monitoring options during VBAC, cutting risks down to realistic size, and providing communication strategies with care providers.
Does CTG misinterpretation harm babies? Or is something else going on?
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 […]
Short term thinking is a problem in maternity care. It seems to me as though a good five minute Apgar score, or normal cord blood gases, is the primary end point in far too many studies. These things are not inappropriate outcomes to aim for, but they aren’t enough and can end up meaning professionals in clinical practice lose sight of the big picture. As a parent and birthing woman, […]
Last week I shared two different research papers highlighting a link between epidural use and caesarean section for abnormal fetal heart rate patterns, pointing out that how these things were connected was not explained by this research. An independent group of researchers, based in Italy, have also recently published research in this area, and their findings provide some additional clues about what might be going on (Ghidini et al., 2023). […]
The journal Ultrasound in Obstetrics and Gynecology published two papers back to back recently. Both are from the same research team based in the Netherlands, and both examined the relationship between use of epidural pain relief during labour and the use of unplanned, in labour, caesarean section or instrumental birth for “presumed fetal compromise”. The research differed in the approach used. Together, the papers raise concern that epidural use might […]
Birth Small Talk 