Does CTG monitoring during labour work?

Does CTG monitoring during labour work?

If you’re looking for information on the current evidence on CTG, read Dr Kirsten Smalls info blog.

Birth Small Talk

Photo by Matt Walsh on Unsplash

If you have read one of my blogs before, you’ll know that I have an interest in research around the use of CTG monitoring, particularly during labour. There’s a widespread misunderstanding about the evidence base, with many people who work in or make use of maternity care services assuming that CTG monitoring improves outcomes for the baby. This post summarises and signposts what I have written previously to make it easier for readers who might want to get across the research themselves.

  • Four things I wish everyone knew about CTG monitoring: This post contains a succinct summary of four key messages.
  • Does intrapartum CTG monitoring save lives? I am the primary author (along with Professor Mary Sidebotham, Professor Jennifer Fenwick and Professor Emeritus Jenny Gamble) of a systematic literature review examining the research about the use of CTG monitoring for women considered to be…

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Come back, Ten Top Tips! Normal birth needs you.

Come back, Ten Top Tips! Normal birth needs you.

Thank you to Oli Silverwood-Cope for taking the time to write this…’building a nest’ was an absolute favourite of mine…


Once upon a slow news week in summer 2017, UK journalists lazily latched onto an out of date factoid: that RCM had axed its normal birth campaign (succeeded by Better Births back in 2014). All references to the campaign disappeared from RCM’s website in May 2017 – including the Ten Top Tipsfor supporting normal birth. Three months later: cue a deluge of disinformation and inflammatory, inaccurate and non-evidence-based reporting on the ‘dangers of normal birth’, from which women need protecting, and the so-called ‘cult’ and ‘overpursuit’ of normality. Midwives were supposedly backpedaling and backing down on normal birth.

Except we weren’t, and we aren’t.

For a start, look at why the normal birth campaign came about: a response to concerns about rising intervention rates and wide variations between different services in terms of planned and unplanned caesarean sections, and operative births, (NHS 2006; Thomas, Paranjothy & RCOG…

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A most courageous friend…💜

babystar Blog

There has been so much to be grateful for since my new diagnosis in April. We have felt many loving arms around us, been warmed by kind words and offers of help. To be honest, I was completely overwhelmed by the influx of beautiful messages following my last blog. Thank you to every one of you who took the time to message or send a card and lighten such a shocking and emotional time with your kindness. I was moved to tears. I do hope you will forgive me for not replying individually to each one? Time has become rather tricky lately! I have always liked to be busy, but I have remembered that having cancer is actually like having a part-time job. Trying to fit in so many medical appointments, plus occupational health & financial planning, etc., around my job as a midwife, Mummy’s Star work, trying to keep…

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Degree of Uncertainty.

If it had been possible to blag my way past security and onto the Right2Water stage on Saturday, this is what I would have said:

“They said when the water charges protest began that it was a threat to democracy. As a human being standing in front of a sea of humanity it’s safe to say, they got that one wrong. We’re the ones saving democracy.
The government, the regime they’d love to take voices like mine out of the equation. Voices at the sharp edge of austerity, voices at the sharp edge of a thousand economic cuts. Let me save them some trouble. Tonight I’ll be sleeping in a psychiatric hospital, up until two months ago I was dependant on methadone, I’ve spent most of my life being controlled in one way or another.  But that does not make what I have to say any less important, any less…

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Why is ownership of national maternity hospital so important…

For the last week we have witnessed the spat over the ownership of the National maternity hospital play out in the media. So many people say ‘why does it matter who owns it’ or ‘women need a state of the art facility’…the answer for me is yes to both these questions, the latter is easier, we know that our three Dublin maternity hospitals are very old and in great need of modernization, reports have told us over the years that co-location is the ideal model of care, with greater outcomes in relation to safety, of this there is no dispute. I am sure that regional maternity units are in equal need of funding and expansion. With such urgency does it matter who owns it? YES it does totally, what this week has shown us is that the thought of the Sisters of Charity owning the new hospital it totally unpalatable to the majority general public and most particularly to those who have been victims of religious abuse. In the recent past we have seen awful tragedies/abuses uncovered before our eyes, the religious have not always served us well in the area of health and education. Of course not every nun or clergy were involved in abusive activities, I like to count a nun as one of the best mentors I had in college and afterward within our work for The Elephant Collective. However it is what they represent historically in an Irish structural context that is so unpalatable and why their non contrition is galling to so many. Someone asked me on twitter why does it matter to me so much, is it worth making such a fuss over for the sake of not having our new state of the art institution? YES it is worth it, I have witnessed with my own eyes the hurt that religious sexual abuse has done to a loved one, the pain is never ending and reaches to the core of their being, it shapes them. It matters to me to in regards to bodily autonomy and agency, the right for a woman to make decisions that are not based on some other persons religious beliefs.  It matters to me especially in regards to the decisions made at the Citizens Assembly today that I can care for equally for women who decide to terminate their pregnancy in the case of fetal abnormality and one who decides to continue it. Nearly 89,000 people signed a petition saying ownership by the religious is not what they want, that has to mean something, women are speaking out, and as healthcare professionals we have to listen. I feel as a nation we have reached a critical turning point, we want and need to separate Church from State to care for women as best we can, so lets we brave,  stand tall and together,  get this right this time for the sake of our future and our children’s future…

woman birth power source

Edited at 20.00

This afternoon on advice I listened to a podcast from the Marian Finucane radio show, I had seen some comments on twitter however not one mentioned Midwife Patricia Hughes who as former Director of Midwifery in the Coombe hospital and now a midwifery advisor. Patricia gave her opinion on the ownership issue. I would advise fellow midwives/obstetricians to listen, Patricia talks so much common sense, particularly her comment that we are now have a great opportunity get the decision right…intimating that decisions as important as these shouldn’t be made on where people to decide to kneel every Sunday but for what is most important, the women and children of our state.!rii=b9%5F21162894%5F70%5F23%2D04%2D2017%5F##


I am not a nun, I am a midwife: maternity care in a “modern” Ireland

My midwifery colleague finding her voice for the women of Ireland…

Feminist Ire

The author of this guest post wishes to remain anonymous.

I attended a protest at the Department of Health yesterday to highlight people’s outrage at the handing over of the new National Maternity Hospital site to the religious order of the Sisters of Charity. I went as a member of Midwives for Choice, and I expected to help hold the banner and maybe video our spokesperson speaking. As it happened she could not, fearful as she was of her job by speaking out against St Vincent’s Hospital Group. So it ended up that I had a microphone and a megaphone pointed in my direction. My reaction? I froze. My voice is an inside my head voice, for the most part; I can’t even speak up in small group conversations mostly. So for anyone who wanted to know why there were midwives behind a banner, here are my thoughts.

I’m already…

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Life is like a box of chocolates…

‘Life is like a box of chocolates’ by the incredibly courageous Nicolette Peel…she likes it that way 💜

babystar Blog

This is quite a tricky post to write. I imagine that most people reading this will know that I have had breast cancer twice, the first time ten years ago when Joe & Ella were 2 & 3yrs, and then again five years ago after Frankie was born. Following various scans & tests since last summer, I was sent for a lung biopsy last Tuesday. The results have shown that the breast cancer has returned, but this time in my lung. Not a new lung cancer, but secondary breast cancer that has travelled to the lung.

Once breast cancer metastases to the lung it is technically incurable, however there are lots of different treatments available to try to keep the cancer under control and prevent it from spreading further. Over the next couple of weeks I will see the oncologist at the Christie to work out an initial treatment plan…

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IMAG0646.jpgAh, you’re not going yet…

This was a regular turn of phrase of my mothers, especially in her last year when her illness took away her freedom to do and to go where she wished, no little secret shopping expeditions on the 33b, no ferreting treasures in the back of the wardrobe to be produced one day with ‘I’ve had that ages’ when complimented on it..

Often I’d come home after a long shift, yearning for bed, I’d call in to say hello physically as well as mentally trying to do my duty, when I felt a reasonable time had passed I’d get up to go, her face would fall and she’d utter ‘ah you’re not going yet’.

On today, mothers day I wish she was here to utter that phrase, I wish I could relive those moments and stay sitting, wait longer and listen more, you’ll miss me when I’m gone she’d say, of course you were right, I do…

Happy Mothers Day Mam…love you x

On The Frightening Realities of Being a Woman in 2017

Read this and felt the fear for myself as a woman but especially for my daughter who probably tightropes incidents like this in her life…

Hi guys!

So for anyone who has spoken to me since January 1st, I have been banging on about starting a blog. I wanted to talk about self care and mental health and make up and baking and life (I mean, I hadn’t quite established an aesthetic, and I use commas way too much, but I was well on my way). Anyway, at the end of January, all my plans for everything changed. And now I’m going to talk about that. Because I think it’s really fucking important that people speak about difficult, shitty times. Also, quite selfishly, I think this will be pretty cathartic. Haven’t started yet but this could potentially be a long read. Buckle up kids.

The Incident.

So I was leaving a well known Clapham Club *cough* Infernos *cough* when a man, a stranger, started making sexual comments at me. The sad thing is, I don’t…

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