What Doctors Don't Tell YouNeither healthy women in labour nor their babies derive any benefit from electronic fetal monitor (EFM) on admission to hospital.
A UK study of 1704 low risk labouring women found that a routine 20 minute session of EFM to check fetal heart rate at the beginning of labour made no difference to the outcome for the baby, but resulted in an increased risk of obstetric interventions for the mother.
The researchers found variations in the way practitioners interpreted the EFM readouts. Also, the fact that a woman was hooked up to the EFM machine made doctors and midwives practice a more defensive type of medicine, such as continuous fetal monitoring, labour augmentation with synthetic hormones, epidural analgesia and operative delivery.
The low risk women subjected to admission EFM had a 5.5 per cent greater chance of a delivery using forceps or ventouse and a 1.5 per cent higher risk of having a caesarean than those who received Doppler auscultation.
Indeed, assessment with Doppler was found to be just as effective at identifying a compromised fetus while having the advantage of not leading to a domino effect of unnecessary interventions (BMJ, 2001; 322: 1457-62).
Maryon Stewart
Daniel Redwood DC
Tom Ferguson MD