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

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 one of two quantitative analyses of survey responses received.

Results: We received 861 valid responses. The most common form of monitoring across all hospital settings was wired CTG (53% of total). Women who used wired CTG were more likely to be primiparous (OR = 3.220, [95%CI:2.080-4.987], p < 0.001), and give birth at a private hospital (OR = 3.017 [95%CI:1.632-5.576], p < 0.001). Women who were monitored via wired CTG were more likely to use pharmacological pain management, and have an emergency caesarean section (p < 0.001), which remained significant when adjusting for epidural. Women who gave birth vaginally were more likely to have been monitored via intermittent auscultation (OR = 3.582, [95%CI:2.007-6.390], p < 0.001), and to use non-pharmacological techniques such as mobility (p < 0.001) and supportive care (p < 0.01). Of the women monitored via wired CTG 58% felt that monitoring had a negative impact on their labour.

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.