Birth Small Talk

Fetal monitoring information you can trust

Tag Archive for ‘guidelines’

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There’s a new RANZCOG fetal monitoring policy: What do they get right and what do they get wrong?

The recent fifth edition of RANZCOG’s fetal monitoring guideline adopts a new approach, providing more accurate summaries of the quality of their evidence. Although it emphasises women’s autonomy, they have not quite completed the task of shifting decision-making from obstetricians.
Australian folks – are you interested in joining me in a workshop in the new year for a detailed look at how to apply the guideline to your practice?

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Are all fetuses the same?

In the past two decades, standardized approaches to cardiotocography (CTG) interpretation have evolved. They don’t take into account that specific fetal heart rate patterns may vary by fetal sex and age. There is a need for individualised interpretation as standard guidelines may not account for all fetal characteristics, potentially leading to misinterpretation and harm.

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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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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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What would a good fetal monitoring policy look like?

Last week I published a post about why I’m not on a guideline writing group. I mentioned that I sometimes provide anonymous gentle suggestions for people who are working on fetal monitoring guidelines about how to make theirs better. You might like to get a copy of the fetal monitoring guideline where you work / where you support women to birth / where you plan to birth and read the […]

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It’s complicated…

One of the problems I see over and over again is the over simplification of complexities in relation to fetal heart rate monitoring in labour. Education and clinical guidelines tend to produce what appear to be logical and straightforward explanations and advice when there is a lot of mud in the pond. Here are two examples: In both of these cases the situations are much more complicated (like this and […]

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