Experiences and outcomes on the use of telemetry to monitor the fetal heart during labour: findings from a mixed methods study |
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| Affiliation: | 1. Division of Nursing, Midwifery and Social Work, School of Health Sciences, The University of Manchester, United Kingdom;2. Department of International Public Health, Liverpool School of Tropical Medicine, United Kingdom;3. Manchester University NHS Foundation Trust, United Kingdom;1. Mercy Hospital for Women, 163 Studley Rd, Heidelberg, VIC, 3084, Australia;2. Werribee Mercy Hospital, 300-310 Princes Hwy, Werribee, VIC, 3030, Australia;3. Northumbria University, Benton, Newcastle-upon-Tyne, NE7 7XA, UK;4. La Trobe University School of Nursing and Midwifery, Bundoora, VIC, 3086, Australia;1. School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong;2. School of Nursing, Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada;1. School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, Australia;2. Rural Department of Nursing and Midwifery, La Trobe University, Bendigo, Victoria, Australia;3. Nursing and Midwifery, Federation University, Gippsland, Victoria, Australia;4. School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia;5. Nursing and Midwifery, Monash University, Frankston, Victoria, Australia;6. College of Health and Biomedicine, Victoria University, Australia;1. Department of Obstetrics and Gynecology, San Gerardo Hospital, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy;2. Department of Obstetrics and Gynecology, MBBM Foundation at San Gerardo Hospital, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy;3. Division of Midwifery, School of Health Sciences, The University of Nottingham, Nottingham, United Kingdom;4. School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy;1. Department of Obstetrics and Gynecology, Máxima MC, P.O. Box 7777, 5500 MB, Veldhoven, the Netherlands;2. Department of Electrical Engineering, Eindhoven University of Technology, P.O. Box 513, 5600 MB, Eindhoven, the Netherlands;3. Eindhoven MedTech Innovation Center (e/MTIC), Eindhoven, the Netherlands;4. Department of Obstetrics and Gynecology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands;5. MMC Academy, Máxima MC, P.O. Box 7777, 5500 MB, Veldhoven, the Netherlands;6. Department of Obstetrics and Gynecology, Catharina Hospital, P.O. Box 1350, 5602 ZA Eindhoven, the Netherlands;1. Faculty of Health and Environmental Sciences, Center for Midwifery and Women’s Health Research, Auckland University of Technology, Auckland, New Zealand;2. School of Nursing, Midwifery and Health Practice, Te Herenga Waka Victoria University of Wellington, New Zealand;3. WHO Collaborating Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hong Kong |
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| Abstract: | BackgroundWireless continuous electronic fetal monitoring (CEFM) using telemetry offers potential for increased mobility during labour. United Kingdom national recommendations are that telemetry should be offered to all women having CEFM during labour. There is limited contemporary evidence on experiences of telemetry use or impacts it may have.AimTo gather in-depth knowledge about the experiences of women and midwives using telemetry, and to assess any impact that its use may have on clinical outcomes, mobility in labour, control or satisfaction.MethodsA convergent parallel mixed-methods study was employed. Grounded theory was adopted for interviews and analysis of 13 midwives, 10 women and 2 partners. Satisfaction, positions during labour and clinical outcome data was analysed from a cohort comparing telemetry (n = 64) with wired CEFM (n = 64). Qualitative and quantitative data were synthesised to give deeper understanding.FindingsWomen using telemetry were more mobile and adopted more upright positions during labour. The core category A Sense of Normality encompassed themes of ‘Being Free, Being in Control’, ‘Enabling and Facilitating’ and ‘Maternity Unit Culture’. Greater mobility resulted in increased feelings of internal and external control and increased perceptions of autonomy, normality and dignity. There was no difference in control or satisfaction between cohort groups.ConclusionsWhen CEFM is used during labour, telemetry provides an opportunity to improve experience and support physiological capability. The use of telemetry during labour contributes to humanising birth for women who have CEFM and its use places them at the centre and in control of their birth experience. |
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| Keywords: | Labour Obstetric Midwifery Fetal monitoring Telemetry Humanising birth Birth environment |
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