What is it about?
A biomechanical model of the way mothers' bodies work in labour suggests that the mother and fetus work together for optimal positioning of the fetus for second stage. CTG works against this mechanism by restricting maternal movement. Forward leaning positions enable the clitoris to cushion the fetal head.
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Why is it important?
The widespread use of CTG prevents the mother and her fetus coordinating their movements to achieve a smoother passage through the tortuous human birth canal. If deemed necessary, EFM should be used in a way that also encourages mothers to move freely.
Perspectives
I hope that this article will reignite an interest in the physiology of labour, so that the mother and fetus are no longer seen as passive participants in a process often defined in terms of 'the powers, the passage and the passenger'. Rethinking physiology could revolutionise maternity care, making birth safer for both mother and baby.
Margaret Jowitt
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This page is a summary of: Electronic fetal monitoring is more important than freedom of maternal position in labour, BJOG An International Journal of Obstetrics & Gynaecology, June 2018, Wiley,
DOI: 10.1111/1471-0528.15026.
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