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Consumer Information on Fetal Heart Rate Monitoring During Labor: A Content AnalysisA Content Analysis

Torres, Jennifer PhD; De Vries, Raymond PhD; Low, Lisa Kane PhD, CNM, FACNM

The Journal of Perinatal & Neonatal Nursing: April/June 2014 - Volume 28 - Issue 2 - p 135–143
doi: 10.1097/JPN.0000000000000035
Feature Articles

Electronic fetal monitoring (EFM) is used for the majority of births that occur in the United States. While there are indications for use of EFM for women with high-risk pregnancies, its use in low-risk pregnancies is less evidence-based. In low-risk women, the use of EFM is associated with an increased risk for cesarean birth compared with the use of intermittent auscultation of the fetal heart rate. The purpose of this investigation was to evaluate the existence of evidence-based information on fetal heart rate monitoring in popular consumer-focused maternity books and Web sites. Content analysis of information in consumer-oriented Web sites and books was completed using the NVivo software (QRSinternational, Melbourne, Australia). Themes identified included lack of clear terminology when discussing fetal monitoring, use of broad categories such as low risk and high risk, limited presentation of information about intermittent auscultation, and presentation of EFM as the standard of care, particularly upon admission into the labor unit. More than one-third of the sources did not mention auscultation, and conflicting information about monitoring methods was presented. The availability of accurate, publically accessible information offers consumers the opportunity to translate knowledge into the power to seek evidence-based care practices during their maternity care experience.

Department of Sociology (Dr Torres), Center for Bioethics, Department of Graduate Medical Education, School of Medicine (Dr De Vries), and School of Nursing; and Department of Women's Studies (Dr Low), University of Michigan, Ann Arbor.

Corresponding Author: Lisa Kane Low, PhD, CNM, FACNM, School of Nursing and Department of Women's Studies, University of Michigan, 400 N Ingalls, Ste 3320, Ann Arbor, MI 48109 (

Funding for this project was received from the Institute for Research on Women and Gender and the CUBE program, University of Michigan.

The authors thank the members of the University of Michigan CUBE funded project: Examination of the clinical and non-clinical factors influencing use of electronic fetal monitoring, Sonya Dal Cin, Scott Greer, and Denise Lillvis.

Disclosure: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

Submitted for publication: January 9, 2014; accepted for publication: February 26, 2014.

© 2014 by Wolters Kluwer Health | Lippincott Williams & Wilkins.