Lotsa reading......

I have been so super busy with lots of reading and writing assignments for midwifery school.

This week in intrapartum, we're reading, discussing and synthesizing multiple aspects of fetal monitoring in labor. Did you know that in low risk women, continuous EFM is no better than intermittent auscultation in labor, as it relates to reducing rates of cerebral palsy? In fact, rates of CP have been unchanged since EFM was first introduced in the early 1970's? Continuous EFM in low risk women actually increases the likelihood of a cesarean section.

Does this mean that I am an uber crunchy granola student midwife who has been brainwashed into believing that continuous EFM (or any EFM!) has no place in birth? WRONG-O!

I have had a belief for many years now that EFM has a time and a place in birth. I feel it's more than appropriate, for a low risk laboring woman to have a baseline fetal monitor strip on admission to labor and delivery to determine adequate fetal oxygenation AT THAT MOMENT IN TIME (admission). After that, I feel that intermittent auscultation, at the appropriate intervals during labor, is best for the low risk pregnant woman and her fetus. If, however, at any point in time that things change from low risk to potentially a higher risk, I don't hesitate to put the fetal monitor back on to reassess the fetus. And yes (GULP!) I believe that interventions are sometimes needed. All on a case by case, moment by moment basis.

Labor and birth is not a cookie cutter process, nor is it an assembly line.