Midwives’ perspectives on the use of intermittent fetal auscultation and continuous cardiotocography during labour

Abstract

Introduction: During labour the fetal heart rate (FHR) and maternal contractions may be assessed by two different monitoring methods: intermittent fetal auscultation (IA) and continuous cardiotocography (CTG). Aim: To explore midwives’ perspectives on the use of IA and continuous CTG during labour. Method: A qualitative research design was chosen. Eight midwives, recruited by purposive sampling from the Central Delivery Suite (CDS) in Malta, were interviewed face to face and audio-recorded using a self-designed, semi-structured interview schedule. Data were then thematically analysed. Findings: Midwives rely on different factors, including risk assessment, labour stages and maternal choice, when choosing the method of fetal monitoring. Furthermore, certain external factors imposed by the obstetric-led nature of the participants’ work setting influenced midwives’ decisions on fetal monitoring. Midwives also highlighted the need of maternal antenatal education regarding fetal monitoring methods, to aid mothers in making informed decisions during labour. Conclusion: The findings of this study provide in-depth information regarding fetal monitoring methods and a solid foundation for further research, emphasising the need for adequate and readily available guidelines on fetal monitoring techniques, providing continuing professional development (CPD) courses regarding IA and CTG for both midwives and obstetricians to increase knowledge and awareness.