Moving with the beat: changing fetal monitoring practices in low-risk labour

Abstract

In current practice electronic fetal monitoring is used extensively to assess fetal well-being in normal or low-risk labour. Within this clinical context there are a number of issues concerning the comparative benefits or problems of this practice when compared with intermittent auscultation. The purpose of this study was to explore factors influencing current practice by systematically investigating and describing changes in practice, encompassing the period of time prior to and following, the introduction of electronic fetal monitoring, and up to the present day. To do this text from the 13 editions of Margaret Myles's ‘Text Book for Midwives’, was subjected to a qualitative content analysis. The data revealed five distinct patterns of practice, each correlating loosely to a calendar decade and each reflecting different norms for childbirth and midwifery practice. The findings suggest that there is a significant shift in the skills and context associated with fetal monitoring, changes that require reflection and debate.