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Hello Robyn, what a great project. Here at our freestanding, women centred, midwifery led birthing Service, the midwives use IA and it is (mostly) 30 mins in first stage (from whenever the women come in to the unit! and some come within an hour of birthing) and then in second phase/stage after each contraction - I would be surprised if it was for the full minute. There are of course variations, like, for example, women whose contractions 'go off' because of one thing or another and they are left to 'rest' and then resume labour after that and IA is resumed when labour does. It would be fabulous to know what different groups of midwives are actually doing and what informs their decision making around that. You would have eight participants in that study from this service as I'm sure everyone would love to be involved in your study. warmly, Carolyn Hastie >>> "Robyn Maude [CCDHB]" <[log in to unmask]> 06/14/07 9:49 am >>> Hello Everyone In March last year, just prior to my first PhD school, I emailed the list to make an initial contact with those of you interested in and/or doing or done some work around fetal moniotiring in labour specifically intermittent auscultation. Since then I have had a really enjoyable year engaging with the literature and have conducted an audit of the practice of fetal monitoring in the hospital where I work. Now I am ready to think about how I may go about designing my research around this aspect of care. The literature frequently points out the lack of evidence around timing, freqency and duration of IA. Current fetal moniotirng guidelines (RCOG/NICE, ACOG, SOGC, RANZCOG etc ) recommned IA for 'low risk' women and have outlined the timing, frequency and duration. These are based on protocols developed for RCT's comparing IA and EFM . Over time these IA guidelines have become common practice without being 'tested'. I am particularly interested in exploring whether IA guidelines (timing, frequency and duration) are appropiate, necessary, are being used, take into account other variables like 1 to 1 care in labour, continuity of care, fetal movements etc My supervisor and I have toyed with a few ideas, but I am keen to hear your ideas as well. Some ideas are : * An RCT comparing 15 min with 30 min auscultation -potentially problematic as the numbers needed to demonstrate no difference would be huge * A survey (nationally, internationally)of current practice around IA and what informs this practice - i.e if midwives' practice does not reflect the current guidelines for IA (i.e 15-30 min in first stage and 5min or after each contraction in second stage, for 1 full minute, after a contraction, comparing with maternal pulse) then what do they do and how do they ressure themselves and women about the baby's well-being in labour? * An international eDelphi study - the creation of international expert midwifery opinion to inform practice around IA * developing a (midwifery) model for IA and testing it I would be grateful for any feedback or advice you could give me. Cheers, Robyn Maude Midwifery Advisor Capital and Coast DHB Private Bag 7902 Wellington South New Zealand Office - Level K - Ward 14 -Grace Neill Block (04) 3855999 ext. 5298 0274793826 This email or attachment(s) may contain confidential or legally privileged information intended for the sole use of the addressee(s). Any use, redistribution, disclosure, or reproduction of this message, except as intended, is prohibited. If you received this email in error, please notify the sender and remove all copies of the message, including any attachments. Any views or opinions expressed in this email (unless otherwise stated) may not represent those of Capital & Coast District Health Board. http://www.ccdhb.org.nz (1C_S1) No Viruses were detected in this message. HealthIntelligence eMail Filter Service