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Have been reading the debate about fetal heart
monitoring with interest. Has anyone been able to find out how often Dutch
homebirth midwives listen to the FH once they do arrive on the scene? I
have heard that they try not to come to the home until they think the birth is
imminent anyway, which says something in itself about their views on the need to
be listening to the FH every half an hour in first stage of labour.
Correct me if I am wrong.
It does seem to be coming from a
medico-legal position that women can labour along at home without any
monitoring ( and we encourage them to do so for as long as they can) but
when they turn up to hospital they all of a sudden get monitored every half an
hour.
Having only worked in the hospital birthing
setting, I have always adhered to this half an hour time frame but from my point
of view it is more for the sake of following hospital policy and protecting
myself medico-legally than from an evidence based rationale.
The debate seems to be heading to whether or not we
should monitor between every contraction or every second contraction in
second stage which is splitting hairs I think. Have not looked on Cochrane to see if any studies have been done on
frequency of intermittent FH monitoring in either first or second stage, but it
seems that the outcomes that they have in Holland could tell us more.
Just a few thoughts to add to the
discussion.
Helen Cahill
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