Intrapartum care: An urgent need to question historical practices and ‘non-evidence’-based,illogical foetal monitoring guidelines to avoid patient harm

Abstract

Childbirth should be a very happy, positive and rewarding experience for the woman, her partner and her family as well as for health-care providers. Women and their families have every right to expect that bringing a new life into this world would be a safe process. However, the latest ‘Each Baby Counts’ Report published by the Royal College of Obstetricians and Gynaecologists in November 2018 has highlighted that out of nearly 700,000 babies born in the UK, 1123 babies died or sustained a severe brain damage during the intrapartum period (i.e., during labour). Despite excellent antenatal surveillance in the UK with regular antenatal clinic visits, ultrasound scans and blood tests as well as the free availability of the cardiotocograph machines to monitor the foetal heart rate during labour, very sadly 124 babies had died during labour. Moreover, 145 babies were born alive but died within the first days after birth, and 854 babies met the criteria for severe brain damage. According to this latest ‘Each Baby Counts’ Report, 71% of babies might have a different outcome with different care, and cardiotocograph misinterpretation accounted for 34% of all cases of poor perinatal outcomes. It is no longer acceptable to continue ‘counting’ our poor perinatal outcomes and produce glossy reports such as the ‘Each Baby Counts’ without scrutinising the underlying causes which are forcing excellent and caring midwives and obstetricians to make bad mistakes in the labour wards.