the only reason to listen to the fh is to assess for fetal wellbeing/coping with the 
stress of labour. the reason you listen before during and after a contraction (not 
everytime, possibly, but certainly if there is any decelerations noted) is to get a 
good'feel' of what the heart rate is doing. i agree that some perfectly normal fh 
patterns can sound scary, however if you KNOW this baby and what it is doing in 
response to labour, you are much better at judging what is happening in regards to any 
decelerations, and consequently, are much less likely to over-react to 'scary' fh 
patterns.

love Bethany 

-----Original Message-----
From: Mary Murphy [mailto:[EMAIL PROTECTED]
Sent: Tuesday, 2 December 2003 16:57
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] fetal heart in labour


I acknowledge that Lesley & I are at odds on this question.  The informed choice 
guidelines ask some very important questions: "How do fetal heart rate patterns 
reflect foetal compromise?  The understanding and interpretation of variations in the 
foetal heart rate are still in it's infancy."  My observation is that there has been 
more harm done to mothers and babies from overzealous monitoring of foetal heart tones 
and the reaction to normal patterns that sound scary, than there has been from the 
more traditional frequency of auscultation. Denise asks a very valid question:
"when does intermittent auscultation become continuous auscultation (listening after 
every contraction?) and an intervention in normal progress of birth?? " Cheers, MM

I would really appreciate some opinions on frequency of listening to the FH in labour, 
particularly the second stage. I've always listened in every half hour in early 
labour, 15 minutely in cracking labour and after every contraction (and through some 
of them) in the second stage. I know of some midwives who do not feel this is 
necessary and so I'd love to hear more opinions. What I wonder is if the FH is not 
being listened in to how would you know whether to expedite the birth? Also if the 
worst happened how would it stand up in court?
Thanks
Lesley
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