I think that empowering the pregnant woman to understand that she is the one who is in charge and therefore the one who knows her unborn baby the best is an absolute no brainer and anything that helps this empowerment is a good thing BUT as a midwife I think that it is absolutely imperative that the pregnant woman and her care provider work in partnership to keep the baby safe. She needs to do her bit by keeping in touch with her maternal intuition, getting to know her baby’s movements and immediately reporting a change, listening to her body and immediately reporting any changes there too. On the other side of the coin is the maternity care provider (Midwife, doctor, obstetrician) they need to match what the mother is doing by carefully monitoring the pregnancy at all the prenatal (antenatal ) visits and listening… TRULY listening to the woman AND acting on her concerns. Problem is this kind of ideal partnership is rare, what typically happens is that the mother quite willingly surrenders herself to her care provider and virtually pays little or no attention to the pregnancy between visits. So if she buys one of these devices to get in touch with her baby then that is probably a good thing.
Now whilst there is nothing wrong with listening in to the baby I think she has to be quite careful about what she is doing and why she is doing it. If she wants to get to know he baby better and thinks this is a good way of doing it she is probably right. BUT if she is using it to check on fetal wellbeing then that’s a whole different ballgame. Listening to the fetal heart only gives you one small aspect of what is happening …literally how many times the baby’s heart is beating in a minute. I have done some palliative care in my time and I can tell you that someone could be on the verge of dying but still have a heart beat and if I all you did was take their pulse it would be difficult to tell they were dying. What is needed is the whole clinical picture, what do they look like, what are they acting like, what else is happening…all these things are vital to tell you what is actually going on. So listening to the heart beat is really not enough on its own. Therefore, if she is listening in and hears a heart beat AND this stops her from listening to her intuition that something is wrong and seeking help from her care provider then that could have potentially catastrophic consequences for the unborn baby
What about the home monitors that send a (NST /CTG) trace to a maternity care provider? There is little doubt that this kind of technology can save lives. The best example of this, that I know of, is Dr Jason Collins who provides a woman with a home fetal monitor and he can then view the heart trace remotely . He has done this for many years and has undoubtedly saved many babies lives as a result. BUT this kind of technology really needs to be taken seriously. So it does concern me that the woman can potentially purchase a fetal monitor without consultation with her care provider and use it to “monitor” her baby. This would be akin to a woman purchasing an ultrasound machine in order to regularly look at her baby. Without the medical knowledge to interpret what she is seeing this could be potentially quite dangerous. Likewise if she is looking at the print out from a fetal monitor without the knowledge of how to correctly interpret the read out then this could potentially provide her with false reassurance.
So home fetal monitoring CAN be a totally brilliant supplement to care BUT it must not be used as a substitute for care.