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The balance of probabilities

02 January 2018
Volume 26 · Issue 1


The ‘Every Baby Counts’ report aims to halve stillbirths by 2020. One area of improvement is fetal monitoring, which, as Claire Axcell explains, can be ameliorated in a variety of ways

During the summer between my second and third year, I explored the subject of fetal wellbeing, from how cardiotocography (CTG) training is delivered, to the legal implications of issues of interpretation.

As part of the Midwifery course, students learn about intermittent and continuous fetal monitoring guidelines, and how and when to use each method. However, although I learnt that I should do these things, I did not necessarily know why. It wasn't until I attended Edwin Chanadrahan's ‘CTG masterclass’, and it was spelled out to me that I was listening and looking for signs of fetal hypoxia (or chemoreceptor decelerations), that I made the link from theory to practice.

Reading a CTG confidently is a skill gained through experience and exposure. Obstetricians must pass an exam on CTG interpretation (Royal College of Obstetricians and Gynaecologists (RCOG), 2017), yet no such standard exists for midwives, and it is down to each Trust to set their own guidelines on fetal monitoring and assessment (RCOG, 2017).

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