Tag Archives: EFM

Evidence-based maternity policy?

20160612_162641-1-1

This post is the text of an article I wrote earlier this year, around the time Better Births, the report of the National Maternity Review, was published. The original title was ‘Stillbirth: what politicians and the media fail to understand.’ What I think many fail to understand is figures and their context – and research evidence more broadly.

It seems to me that we can only have consistently evidence-based health policy when we have a  shared commitment in public life, and in public discussion, to a National Information Standard for talking about research evidence, and indeed for promoting public health messages. 

Why do I keep tweeting NICE CG138 s1.5.24 –  which is a National Information Standard, if people will choose use it? Those of you who have read ‘Thinking Fast and Slow‘ will understand why we need it: thinking about risk often involves ‘shortcuts’ and ‘rules of thumb’ that serve well in some cases, and less well in others (another blog post is needed to explore the topic!) We can, of course, support Each Baby Counts and the work of MBRRACE-UK, and acknowledge that addressing stillbirth rates is very important, while being equally clear that each and every time data is presented it must be properly contexualised. It serves women, their babies, and their families, poorly to present information without using absolute figures, framed both ways, (when possible) in a variety of formats.

So I wrote this article to express my frustration – that the public is so often presented with partial information, or information without context. And that this ‘problem with figures’, and indeed with understanding research evidence more broadly, seems to extend to, and affect, public policy initiatives. Continue reading

CG190 Fetal monitoring in labour (CTG)

My second CG190 blog on monitoring the fetal heart rate – this time focusing on CTG use and trace interpretation. What is the evidence, and what is new and different about these recommendations? (Please do also read my previous post to understand this summary in context.) Again, I am assuming a basic familiarity with the evidence.

While writing this post, I have come across this fabulous resource of which I was unaware!  Here on NCBI is a fully interactive version of Chapter 10 including Appendix P (all the Appendices are there!) Recommendations below are from the NICE online version and the Full guideline is here (with Appendices) on the NICE website, along with pathways, and the Quality Standard.

Note that significant sections of the CG190 fetal monitoring recommendations have been brought within the scope of the Intrapartum Care guideline for women at higher risk of complications currently being developed – see link below  (under ‘Resources’) for full details. See introduction to my previous post too.

(28 May 2016, published 5 June 2016) Continue reading