What Do Women Want? Consent for the Use of Electronic Fetal Monitoring

BACKGROUNDGuidelines published by professional associations of midwives, obstetricians, and nurses in the United States recommend against using continuous cardiotocography (CTG) in low-risk patients. In the United States, CTG or electronic fetal/uterine monitoring (EFM) rather than auscultation with a fetoscope or Pinard horn is the norm. Interpretation of the fetal heart rate (FHR) and uterine activity (UA) tracings provided by continuous EFM may be associated with the decision for a cesarean birth. Typically, consent is not sought in the decision about type of monitoring. No studies were identified where women's attitudes about the need to consent to the type of fetal monitoring used during labor have been explored. Therefore, the purpose of this research was to examine women's attitudes about the use of EFM in a healthcare setting.METHODSWe asked a sample of women aged 18–50 years to respond to one of three monitoringscenarios. The scenarios were used to distinguish between attitudes about monitoring in general, monitoring the health of a mother in labor, and monitoring the health of the fetus during labor. Wemeasured their level of interest in being monitored and their opinions about whether healthcare providers should be required to obtain consent for the monitoring described in the scenario.RESULTSInterest in receiving monitoring (across all three scenarios) was moderate, with the highest level of interest in monitoring the fetus during labor and the least interest in monitoring a general health context. Across all scenarios, 82% of respondents believed that practitioners should obtain consent for monitoring, 14% were unsure, and 4% said there should not be a requirement for consent. While low (6%), the percentage responding that consent was not needed was highest in monitoring a fetus in labor.CONCLUSIONSWomen in our study expressed a strong preference for the opportunity to consent to the use of monitoring regardless of the healthcare scenario. There is findings suggest the need for further research exploring what women do and do not know about CTG and what their informed performance are a pressing need to rethink the role of a pressing need to rethink the role of shared decision-making and informed consent about the type of monitoring use during labor.

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Healthy Birth Practice #4: Avoid Interventions Unless They Are Medically Necessary

The Journal of Perinatal Education ◽

10.1891/1058-1243.28.2.94 ◽

2019 ◽

Vol 28 (2) ◽

pp. 94-103

Author(s):

Judith A. Lothian

Keyword(s):

United States ◽

Epidural Analgesia ◽

Maternity Care ◽

Fetal Monitoring ◽

The United States ◽

Unintended Consequences ◽

Intravenous Fluids ◽

Electronic Fetal Monitoring ◽

Increase Risk ◽

Continuous Electronic Fetal Monitoring

Maternity care in the United States continues to be intervention intensive. The routine use of intravenous fluids, restrictions on eating and drinking, continuous electronic fetal monitoring, epidural analgesia, and augmentation of labor characterize most U.S. births. The use of episiotomy has decreased but is still higher than it should be. These interventions disturb the normal physiology of labor and birth and restrict women's ability to cope with labor. The result is a cascade of interventions that increase risk, including the risk of cesarean surgery, for women and babies. This paper describes the use and effect of routine interventions on the physiologic process of labor and birth and identifies the unintended consequences resulting from the routine use of these interventions in labor and birth.

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The History of Occupational Therapy Assistants in Canada: A Comparison with the United States

Canadian Journal of Occupational Therapy ◽

10.1177/000841740106800405 ◽

2001 ◽

Vol 68 (4) ◽

pp. 217-227 ◽

Cited By ~ 11

Author(s):

Penny Salvatori

Keyword(s):

United States ◽

Occupational Therapy ◽

Professional Associations ◽

Training Model ◽

The United States ◽

Professional Affiliation ◽

Standards Of Practice ◽

History Of ◽

And Training

In the middle of the twentieth century, the role of occupational therapy assistant was introduced in North America. Although the role, utilization and training of assistant personnel have raised much controversy and debate within the profession, Canada and the United States have taken very different paths in terms of dealing with these issues. This paper focuses on the history of occupational therapy assistants in Canada, using the experience in the United States for comparison purposes. The occupational therapy literature and official documents of the professional associations are used to present a chronology of major historical events in both countries. Similarities and differences emerge in relation to historical roots; training model and standards of education; certification, regulation, and standards of practice; career laddering and career mobility; and professional affiliation. The paper concludes with a summary of issues which require further exploration, debate and resolution if the profession is to move forward in Canada.

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The status of the profession: the role of PhD and masters programs in public policy education

Policy Analysis in the United States ◽

10.1332/policypress/9781447333821.003.0018 ◽

2018 ◽

Author(s):

Nadia Rubaii

Keyword(s):

United States ◽

Public Policy ◽

Professional Associations ◽

The United States ◽

Public Affairs ◽

Graduate Level ◽

Fields Of Study ◽

The Status ◽

Similarities And Differences

This chapter traces the evolution of graduate level public affairs education in the United States in terms of focus, mission, curriculum, institutional locus, and enrollments, with attention to similarities and differences at the masters and doctoral levels. It highlights the role of two key professional associations in the evolution of the field, NASPAA and APPAM. It also examines some persistent challenges regarding how broadly or narrowly to define the field, how clearly to differentiate among the related fields of study, and how to define and ensure quality.

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Electronic Fetal Monitoring in the United States

Birth ◽

10.1111/j.1523-536x.1994.tb00243.x ◽

1994 ◽

Vol 21 (2) ◽

pp. 105-106 ◽

Cited By ~ 7

Author(s):

Bruce L Flamm

Keyword(s):

United States ◽

Fetal Monitoring ◽

The United States ◽

Electronic Fetal Monitoring

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Linking students and professional associations: A curricular strategy

The Journal of Practice Teaching and Learning ◽

10.1921/jpts.v15i3.1240 ◽

2018 ◽

Vol 15 (3) ◽

pp. 5-24

Author(s):

Shirley Simon ◽

Susan F Grossman

Keyword(s):

United States ◽

Social Work ◽

Professional Education ◽

Professional Associations ◽

The United States ◽

Education Professional ◽

Education Professional Development ◽

Association Meeting ◽

Social Work Programs

Students in professional social work programs in the United States traditionally receive little direct information about or contact with professional associations. What exposure they do get is haphazard and primarily through extracurricular means. This article describes and evaluates a curricular module to enhance student awareness of and connection to professional associations. The group work classes at a Midwestern United States university were adapted to include a course module addressing the role of professional associations. Components of the module include readings, discussions, presentations and attendance at a professional association meeting. Pre- and post-tests were administered to assess the initial impact of this module. The module appears to have had an impact upon students’ knowledge of and appreciation for professional associations. The authors advocate for increased curricular attention to facilitating this connection.Keywords: professional associations; social work curricula; professional education; NASW; MSW education; professional development

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Electronic Fetal Monitoring in the United States

Obstetric Anesthesia Digest ◽

10.1097/01.aoa.0000446310.96058.ae ◽

2014 ◽

Vol 34 (2) ◽

pp. 97-98

Author(s):

C.V. Ananth ◽

S.P. Chauhan ◽

H.Y. Chen ◽

M.E. D’Alton ◽

A.M. Vintzileos

Keyword(s):

United States ◽

Fetal Monitoring ◽

The United States ◽

Electronic Fetal Monitoring

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A Narrative Systematic Literature Review: A Focus on Qualitative Studies on HIV and Medication-Assisted Therapy in the United States

Pharmacy ◽

10.3390/pharmacy9010067 ◽

2021 ◽

Vol 9 (1) ◽

pp. 67

Author(s):

Alina Cernasev ◽

Sunitha Kodidela ◽

Michael P. Veve ◽

Theodore Cory ◽

Hilary Jasmin ◽

...

Keyword(s):

United States ◽

Literature Review ◽

Healthcare Providers ◽

The United States ◽

Hiv And Aids ◽

Opioid Use ◽

Screening Process ◽

Persons Living With Hiv ◽

Opioid Medications

Over the last two decades, the United States (U.S.) has experienced an opioid crisis that has had a significant negative societal and economic impact. Due to the high utilization of opioids in Persons Living with HIV and AIDS (PLWHA), there is a need for a qualitative literature review that presents opioid-use related problems in this population. This study aims to present and identify a thematic overview of the qualitative manuscripts on PLWHA who take opioid medications in the U.S., with a focus on perceptions surrounding medication assisted therapy. The systematic literature search was performed in December 2019. Four databases were searched: PubMed/MEDLINE, Scopus, Web of Science, and Cumulative Index to Nursing & Allied Health Literature (CINAHL). A total of 5348 results were exported from databases into EndNote x9, and duplicates were removed for a total of 3039 unique abstracts to screen. The records were imported into Rayyan, an online platform designed to expedite the screening process. Three authors screened titles and abstracts and determined 19 articles that would be screened in full text. On 9 April 2020, it was determined that eight articles would be included for review. The analysis of the eight manuscripts that fit the inclusion and exclusion criteria revealed barriers and facilitators to medication assisted therapy (MAT) in PLWHA. This review communicates or describes the story of PLWHA who might have delayed access to HIV healthcare providers and the commencement of antiretroviral therapy. In the literature, several studies have focused on the role of physicians in prescribing and addressing the medication regimens but none of the studies examined the role of pharmacists in access to care in this population. Therefore, further research is needed for a better understanding of the social aspects of taking opioid medications in PLWHA and the role of pharmacists within the continuum of care.

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The Fetal Monitoring Debate

PEDIATRICS ◽

10.1542/peds.63.6.942 ◽

1979 ◽

Vol 63 (6) ◽

pp. 942-951

Author(s):

John C. Hobbins ◽

Roger Freeman ◽

John T. Queenan

Keyword(s):

United States ◽

Growth And Development ◽

Medical Technology ◽

Fetal Monitoring ◽

The United States ◽

Electronic Equipment ◽

Fetal Anomalies ◽

Electronic Fetal Monitoring ◽

Fetal Surveillance

Medical technology has improved at a staggering pace, and perhaps obstetrics is the field most affected by this progress. obstetrician now depends on information from electronic equipment to follow growth and development of the fetus, to diagnose fetal anomalies, and to assess the fetus's condition before and during birth. Since the equipment used for fetal surveillance is expensive to develop, acquire, and maintain, the technology has contributed somewhat to the rising cost of managing pregnancy. Since its intrOduction in 1960, electronic fetal monitoring (EFM) has become a Widely utilized modalitv. and it is estimated that the technique is used in Over half the labors in the United States.

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The Role of the Legal System in the Cesarean Childbirth Controversy

Nursing, Law & Ethics ◽

10.1017/s0270663600001175 ◽

1980 ◽

Vol 1 (10) ◽

pp. 1-8

Author(s):

Judy Miller

Keyword(s):

Birth Rate ◽

Nursing Practice ◽

Fetal Monitoring ◽

Fetal Distress ◽

The United States ◽

Cesarean Birth ◽

Threefold Increase ◽

Cesarean Births ◽

Patient Advocates

The threefold increase in the cesarean birth rate in the United States during the last ten years has caused much concern among the general public and some medical professionals. Nurses particularly have shared this concern as the scope of nursing practice has expanded and nurses increasingly see themselves as patient advocates. Obviously, not all cesarean births are unwarranted. The procedure may be indicated if there is maternal or fetal risk during labor, if attempted induction of labor fails, and/or if an emergency mandates immediate delivery which is not possible or suitable vaginally.A recent review of over 1,000 U.S. and foreign research articles cites three general reasons for the increasing cesarean birth rate: use of the operation for breech presentations and for repeat sections; the need for early intervention due to fetal distress as determined by the increasing use of fetal monitoring; and physicians' fear of malpractice suits. The first two reasons are matters of medical controversy.

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