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Recently I returned to teaching prenatal classes after an absence of 18 months. In my first class was a young girl who had been told that her baby was breech. She asked me if I would come with her and her husband in labor. I agreed, anticipating a chance to find out what was new at her teaching hospital and to help her, as well. A few weeks later I got her call, drove over and made my way up to her little labor room. For five minutes we talked. Then she panted quietly and rubbed her abdomen, her husband holding her other hand. At this point the door was propped open and a cabinet-sized machine was rolled into the room, pushed by a nurse. It stopped next to the bed, with a brief pause for the removal of the husband's chair to the corridor outside. The hand which had held the husband's was searched for a vein, and an intrevenous drip of glucose installed. The other arm was connected to a continuous blood pressure gauge. The abdomen was encircled with two belts and the electronic devices on the belts were squirted with jelly and planted firmly on the mother's abdomen, the belts then tightened securely. The monitor was turned on and out rolled a continuous strip of paper bearing the fetal heart rate tracing, the uterine contraction tracing, and the blood pressure tracing. The husband found a perch on a window sill across the room. For the next 7 hours a nurse or resident would come in at 30 minute intervals, study the tracing carefully, and tell the mother that all was well.

In the next weeks I learned that nearly half of the women in my classes were being monitored, and the trend has increased in many areas. As a parent educator, I needed to know about fetal monitoring. Are the benefits so great as to justify such absolute domination of labor by machines? Is monitoring too complex to explain ahead of time to parents? I was disturbed by the lack of personal contact on the part of the staff, by the unseated husband and the lack of mobility of the mother. These worries led me to begin a search of the literature and correspondence with monitor manufacturers and several obstetricians who have pioneered in their development.