Monitoring Your Baby in Labor - Myths and Misconceptions
In this podcast episode, I sit down with Dr. Kirsten Small to discuss the lack of evidence and potential harms associated with continuous CTG (cardiotocography) monitoring during labor. Dr. Small provides an insightful critique of this common practice, shedding light on its limitations and the need for informed consent in maternity care. Our conversation explores the importance of self-advocacy for pregnant women, alternative monitoring methods, and the specific concerns of VBAC mothers regarding CTG monitoring.
Key Takeaways
Lack of Evidence for Continuous CTG Monitoring: Dr. Small highlights that there is insufficient evidence to support the routine use of continuous CTG monitoring during labor and birth. Despite its widespread use, continuous monitoring has not been shown to improve outcomes for mothers and babies and may lead to unnecessary interventions.
Fear of Litigation and Established Practices: One of the challenges in changing monitoring practices is the fear of litigation and concerns about professional reputation. Dr. Small discusses how these fears can drive hospitals to continue using CTG monitoring, despite the lack of strong evidence supporting its efficacy.
Hospital Policies and Limited Choice: Many hospitals enforce policies that limit the monitoring options available to pregnant women. Dr. Small emphasizes the importance of empowering women to make informed decisions about their monitoring method and advocating for more choices in maternity care.
Potential Harms of CTG Monitoring: Our conversation delves into the potential harms of continuous CTG monitoring, including its inaccuracy, the risk of misinterpretation, and the cascade of unnecessary interventions it can trigger. Dr. Small argues that the overreliance on CTG monitoring may lead to more harm than benefit for both mothers and babies.
The Need for Alternative Monitoring Methods: Dr. Small stresses the importance of exploring and implementing alternative monitoring methods that are more evidence-based and less intrusive. This could provide a more balanced approach to fetal monitoring during labor.
VBAC and CTG Monitoring: We discuss the limited research on the use of CTG monitoring for women attempting a VBAC (vaginal birth after cesarean). Dr. Small points out the lack of clear evidence guiding monitoring practices for this specific group and the need for individualized care.
Training for Birth Professionals: Dr. Small emphasizes that training and education on fetal monitoring are crucial for birth professionals to provide evidence-based care. Proper understanding and interpretation of CTG readings can minimize the risks associated with over-intervention.
Self-Advocacy for Monitoring Choices: A key theme throughout our conversation is the importance of self-advocacy for pregnant women. Dr. Small encourages women to ask questions, understand their options, and make informed decisions about their care during labor.
Rethinking Routine Monitoring in Birth
Our discussion with Dr. Kirsten Small highlights the need for a more evidence-based approach to fetal monitoring during labor. By questioning established practices, advocating for choice, and seeking alternative methods, we can improve birth experiences and outcomes for mothers and babies.
For more insights on this topic, including training and educational resources for birth professionals, visit Dr. Small's website at birthsmalltalk.com. You can also connect with her on social media:
X (Twitter): @birthsmalltalk
Instagram: @birthsmalltalk
Facebook: birthsmalltalk
To explore this conversation further watch the full episode below.
Empowering pregnant women with knowledge and choices is key to achieving better birth outcomes.
