What about fetal monitoring?

Another area in which common practice or hospital policy often diverges from evidence based pratice. Women in hospitals commonly experience electronic fetal monitoring as a matter of course, particularly an “admission strip” on the baby and then at least 15 minutes of monitoring throughout labor. ACOG itself has recommended that routine continuous fetal monitoring be dropped from the standard of care for low-risk pregnant women and instead recommends intermittent fetal heart tone listening (which can be done with a hand held doppler instead of a fetal monitoring belt). Still, at least 85% of women giving birth in the US have electronic fetal monitoring even thought their practitioners own trade union (ACOG) does not specifically recommend it. Additionally, “electronic fetal monitoring without access to fetal scalp sampling” is on A Guide to Effective Care in Pregnancy and Childbirth table of forms of care likely to be ineffective or harmful. This exhaustive research summary of evidence based care practices for pregnant women also nots that there is insufficient data to support or to disprove the use of short periods of electronic fetal monitoring upon admission to the hospital.

Continuous electronic fetal monitoring with scalp sampling vs. intermittent ascultation (listening) during labor is included on the table of tradeoffs between benefits and harm. the book suggests that women and caregivers weigh the effects of those practices according to circumstances, priorities, and preferences  (this is the same table under which epidural analgesia is classified).

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