Encouraging awareness of fetal movements is harmful…...really???
Now that’s what I call calling a spade and spade!
However, I’m not sure that the reported 9% reduction in stillbirth could EVER be seen as harmful especially as the ‘harm’ is a reported increase in CS rates of 6.3% and term IOL by 3.5%.
The problem with the AFFIRM trial and the ARRIVE trial and others like them is that because the intervention was not objective ...black and white (take this drug or this placebo) it could very easily have been adopted differently by different hospitals and care-providers within the hospitals, AND because women can get their information about fetal movements from many other sources other than the trial’s protocol AND that care-providers can, and do, act in ways that are not in keeping with the trial protocol AND S**T happens it is difficult (and I am actually coming to believe, impossible) to control for all those variables such that a RCT that has ended up demonstrating a 9% reduction in stillbirth has my tick of approval for the effectiveness and value of making women aware of the importance of fetal movements!
It is a real shame that the authors powered their study on a 30% reduction which (with the benefit of hindsight) they must now be regretting because a 9% reduction in stillbirth is definitely NOT harmful, a 9% reduction in stillbirth is amazing, a 9% reduction is spectacular number of babies saved.
The AFFIRM trial shows that when mothers are made aware of their babies movements and the maternity care provider acts in a standardised fashion that you can reduce your stillbirth rate by 9%.......would someone please tell me how that is anything other than really really good?