Intermittent Auscultation (IA) or hands on listening,is a method of listening to the baby during labor. As the first part of the term (intermittent) implies, listening is not done continuously so a laboring person is able to move freely and even get into the tub or shower without being encumbered by straps or probes. Even better, the effectiveness of this form of fetal monitoring has been studied extensively and found to be evidence based. For a comprehensive review of the literature on fetal monitoring, check out this article at Evidence Based Birth.
Because most pregnancies (89% according to the Listening to Mothers III survey) in the US are monitored using electronic fetal monitoring (EFM), the standard of care (which drives most liability cases for maternity care) leans heavily on an assumption of availability of a continuous fetal monitor, despite a significant lack of evidence around the benefits. And because the majority of our customers provide services in out-of-hospital birth settings where intermittent auscultation is the standard of care, Maternity Neighborhood has updated the documentation workflow for IA to better describe the monitoring rigor applied by this method.
Our clinical expert partner for this update was the Clinical Director for Baby+Company, Margaret Buxton, DNP, CNM. “IA is the gold standard of care for low-risk women, therefore midwives need to be the experts on how to do it,” Margaret said in our recent webinar on our clinical update.
The change included a discrete method for evaluating and re-evaluating baseline fetal heart rate (FHR) in labor. The establishment of baseline is a key piece of data for ongoing FHR measurement. The FHR pop-up window now lets you set Baseline (or re-evaluate it) every time to document the results of listening to the baby.