Keeping Childbirth Natural and Dynamic

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Keeping Childbirth Natural and Dynamic

• Discontinuation of admission CTG
• Honor MacGregor
• Karen King

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• Discontinuation of admission CTG
• Risk assessment
• Healthy women
• Uncomplicated pregnancies

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• When did we discontinue the admission CTG?
• Following RCT in Ninewells in 2001
• Doppler v cardiotocography on admission
• CTG has no benefit to neonates
• Admission CTG results in increased obstetric
  intervention
• KCND

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• Fears and barriers
• Cultural
• Comfortable
• Blame
• Time/clinical activity
• Womens expectations

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• Strategies for implementation
• Multidisciplinary
• Education/Grand round
• Peer support/reflection
• Reminders
• Reassurance
• Midwifery skills

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• Current position
• Clinical risk
• Missed risk factor
• Evidence
• Indication
• Outcome

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