Differences in women’s experiences of labour according to type of fetal monitoring: a quantitative analysis of an Australian national survey

Abstract

INTRO: While monitoring of the fetal heart rate in labour is recommended, few studies have compared women’s experiences of different forms of monitoring technologies, their impact on labour and perceived risks and benefits. METHODS: The Women’s experiences of Monitoring Baby (WOMB) study, an Australian national survey, examined experiences of intrapartum fetal monitoring in labour. This study is a quantitative analysis of selected survey responses received. RESULTS: We received 861 valid responses. The most common form of monitoring across all hospital settings was wired CTG, which was significantly more likely for primiparous women (p < 0.001), and at private hospitals in a metropolitan area (p < 0.001). Women who were monitored via wired CTG were more likely to use pharmacological pain management, and have an emergency caesarean section, including when epidural was controlled for (p < 0.001). Women who were monitored via intermittent auscultation were more likely to use non-pharmacological techniques such as mobility (p < 0.001) and supportive care (p < .01), and more likely to have a vaginal birth (p < 0.001). Women monitored via wired CTG were also more likely to ‘agree’ or ‘strongly agree’ that monitoring had a negative impact on their labour (p < .01). CONCLUSION: This study has substantial implications for research, policy and practice, including the implementation of less invasive and more humanised forms of fetal monitoring. The promotion of freedom of movement and bodily autonomy in labour is essential. This includes implementation of evidence-based practices and information about methods of fetal monitoring that support woman-centred care and optimise physiological processes.