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Utilising the unborn baby's in-labour movements

Abstract:

Aspects of midwifery practice, just as in obstetrics, can be validated in the absence of quality evidence simply because many repeat a certain action. Listening to the unborn baby’s heart rate every 15-30 minutes in labour and after every contraction when the woman is pushing is one such practice (World Health Organisation, 1996). However good the intent is to counter intervention-inducing electronic foetal monitoring (EFM), it has developed the authority of a prescribed practice – not because it has shown to be of benefit but because it is has been acknowledged as a common midwifery practice. Those who are familiar with an undisturbed labour scene acknowledge that lack of stimulation enables the primitive brain to help the woman to be ‘on another planet’. Any stimulus to the neocortex of the brain makes the labouring woman more alert, and can inhibit her labour (Odent, 1999), thus intellectual stimulation is to be avoided. While intermittent auscultation is less invasive to the woman’s ‘birthing head’ than EFM, any disturbance to the woman in labour has the potential to interrupt physiological birthing. It becomes imperative to consider other ways to assess and monitor the unborn baby and to utilise what exists in the physiological labour state.

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auscultation, fetal movement during labour, physiological birthing