Monitoring The Fetus In Labor: Evidence to Support the Methods


  • Leah L. Albers CNM, DrPH, FACNM

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    • Leah Albers was in full-scope midwifery practice for 11 years and then completed the DrPH at the University of North Carolina School of Public Health. Since 1991, she has been a midwifery teacher and researcher at the University of New Mexico. She spent a sabbatical year (1997–1998) at the National Perinatal Epidemiology Unit in Oxford, United Kingdom.

University of New Mexico College of Nursing, Nursing/Pharmacy Bldg., Rm 216, Albuquerque, NM 87131-5688.


Electronic fetal monitoring (EFM) was implemented across the United States in the 1970s. By 1998, it was used in 84% of all U.S. births, regardless of whether the primary caregiver was a physician or a midwife. Numerous randomized trials have agreed that continuous EFM in labor increases the operative delivery rate, without clear benefit to the baby. Intermittent auscultation (IA) is safe and effective in low-risk pregnancies and may play a role in helping birth remain normal. Clinicians and educators are encouraged to reconsider the use of IA in the care of healthy childbearing women.