Don’t give your power away in pregnancy and birth There is something subtle (or obvious) happening when we step into the hospital to book our
Women have sat in circles for centuries. There are accounts of women getting together to bleed in women’s circles called red tents or just gathering
1.When did we start monitoring babies in labour?
For more high quality evidence around fetal monitoring please visit Kirsten website here, an obstetrician with a PHD in CTGs. https://birthsmalltalk.com/
In this post she discusses intermittent auscultation: https://birthsmalltalk.com/2023/08/23/what-is-intermittent-auscultation/
Hear her talk about the lack of evidence behind CTGs in this podcast: https://open.spotify.com/episode/1eXZY973Oxbs1ducavpSAk?si=872f8c4077be4ba5
Post on the history of fetal heart monitoring: https://birthsmalltalk.com/2023/08/09/listening-to-the-fetus-the-history-of-fetal-heart-rate-monitoring/
Cochrane review comparing CTG to intermittent ausculation (CTG increases interventions
): https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006066.pub3/full
Does CTG use improve outcomes for high risk women? https://birthsmalltalk.com/2024/10/16/the-story-behind-our-paper/
2. How should we use intermittent auscultation in labour?
These are the NICE guidelines for fetal monitoring in labour: https://www.nice.org.uk/guidance/ng229/chapter/Recommendations
Midwife researcher and lecturer Rachel Reed has a brilliant article and podcast about this where she unpicks the evidence around the recommendations for intermittent auscultation protocols here https://www.rachelreed.website/blog/listening-to-baby-during-labour
and podcast here: https://open.spotify.com/episode/3sJeIR3xUOr20EBRGilHxl?si=818537594dd04457
The WHO recommendations for intrapartum care: https://iris.who.int/bitstream/handle/10665/260178/9789241550215-eng.pdf?sequence=1
3. How does intermittent auscultation detect fetal distress?
For more on normal and abnormal heart rate monitoring watch this explanatory video: https://www.youtube.com/watch?v=Ni48bbtiZgs
4. What happens if there are concerns with the fetal heart rate at a homebirth?
NICE guidelines for fetal monitoring in labour: https://www.nice.org.uk/guidance/ng229/chapter/Recommendations
5.What is better for fetal monitoring in labour: a Doppler or a Pinard/fetoscope?
To read about the research and the experiences of midwives using a fetoscope/pinard antenatally and in labour check these links out.
Short facebook comments compiled in this magazine here: https://www.midwiferytoday.com/mt-articles/wisdom-of-the-midwives-issue-131/
Midwives perceptions of fetoscope vrs Doppler Tanzania https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-018-1736-y
Midwives experiences of Pinard use Norway https://www.sciencedirect.com/science/article/pii/S0266613822000407
Defense of fetoscope article by American midwives
A Cochrane review that compares Doppler and Pinard use in low income countries: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008680.pub2/full
For a compilation of research that compares the use of Doppler to Pinard check this link: https://www.cochranelibrary.com/content?templateType=related&urlTitle=%2Fcentral%2Fdoi%2F10.1002%2Fcentral%2FCN-01110791&doi=10.1002%2Fcentral%2FCN-01110791&p_p_id=scolariscontentdisplay_WAR_scolariscontentdisplay&_scolariscontentdisplay_WAR_scolariscontentdisplay_action=related-content&p_p_lifecycle=0&p_p_mode=view&type=central&contentLanguage=
6. What if you decline some or all fetal auscultations?
Is fetal monitoring essential?: https://birthsmalltalk.com/2024/11/06/myth-busting-3-fetal-monitoring-is-essential/
7. What to bear in mind about intermittent auscultation in labour?
Examples of womens experiences of fetal auscultation in labour: https://www.sciencedirect.com/science/article/pii/S1871519224002658#bib14
