Thanks 2025 – and now on to 2026!
In 2025, I published 46 blog posts attracted 26,800 readers, and had over a million views on Facebook. I have big plans for 2026 – read on to find out more. Subscribe so you don’t miss out on any of the new things!
There’s a new RANZCOG fetal monitoring policy: What do they get right and what do they get wrong?
The recent fifth edition of RANZCOG’s fetal monitoring guideline adopts a new approach, providing more accurate summaries of the quality of their evidence. Although it emphasises women’s autonomy, they have not quite completed the task of shifting decision-making from obstetricians.
Australian folks – are you interested in joining me in a workshop in the new year for a detailed look at how to apply the guideline to your practice?
Why artificial intelligence systems for fetal monitoring are so seductive to healthcare systems (and why that is a huge ethical problem)
Fetal heart rate monitoring traditionally involves professionals interpreting patterns, but technology has introduced complex, expensive systems aimed at improving outcomes. Despite this, there are ethical concerns regarding women’s consent and data use. The focus appears to prioritize cost reduction for healthcare systems over meaningful enhancements in maternal and fetal care outcomes.
Should fetal blood sampling become a thing of the past?
Fetal blood sampling (FBS) has a long history but faces ongoing debates about its relevance. Current evidence shows poor predictive capabilities, and the reliability of fetal blood lactate testing remains disputed. FBS is another example of a fetal monitoring technology that lacks a firm evidence base.
Does CTG monitoring education actually work?
The introduction of the Fetal Surveillance Education Program (FSEP) has been claimed to improve neonatal outcomes. However, the raw data suggests otherwise. A comprehensive literature review indicates inconsistent evidence for CTG training benefits. CTG education should not be mandatory!
Routine umbilical cord gas analysis – is it worth it?
Routine cord blood gas analysis – harmful or helpful?
Digital fetal monitoring and ethics
I have lived through the rapid evolution of digital technologies. While digital tools offer new possibilities, they also raise ethical concerns, particularly with fetal monitoring. We need to talk about the ethics of digital fetal monitoring more than we currently are.
Is Australia on track to make birth safer?
In 2023, Australia recorded 218,099 births, with a rising cesarean section rate, now exceeding 40%. Induction rates and maternal age increased, while the perinatal mortality rate also rose to 11.0 per 1,000. Despite efforts to enhance birth safety, outcomes show concerning trends, necessitating reconsideration of the high rates of intervention.
Why bother?
If you have been hanging around Birth Small Talk for more than a moment, you’ll know I’m very focussed on putting the evidence about fetal heart rate monitoring in front of as many people as possible. And you’ll know that this position puts me at odds with a lot of what most people will hear in mainstream maternity services. So I get some pushback from time to time. And even […]
Human rights and artificial intelligence in healthcare
Recent publications on fetal monitoring highlight the rise of artificial intelligence (AI) in interpreting CTG recordings. While advancements promise decision-support systems, rights issues remain. Ploug and colleagues emphasize the need for regulations in AI-driven healthcare to protect people’s rights, urging the integration of these considerations into technology development from the outset.
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