Two papers from Listen2Baby published

Published on Tuesday, 22 April 2025 Post

The Listen2Baby team are celebrating the publication of two papers.

The first, Intermittent auscultation fetal monitoring practice in different UK birth settings: a cross-sectional survey, led by Megan Douthwaite and colleagues, has been published in BMC Pregnancy and Childbirth. Drawing on responses from 174 maternity units in 119 NHS organisations across the UK, the study provides the first national picture of how intermittent auscultation (IA) is used in practice.

The authors report that while most units had local IA guidance and required annual IA training and competency assessment, almost one in five did not; only around a third reported an annual IA audit; at least six different fetal heart rate counting methods were in use; and fewer than half had implemented a “fresh ears” buddy system. The findings demonstrate substantial variation in IA guidance, training, audit and practice across birth settings, and highlight the urgent need for robust evidence to inform best practice and standardised IA guidance.

The second paper, published in Women and Birth, reports on a qualitative study led by Jennifer MacLellan and colleagues and explores women's experiences of intermittent auscultation fetal monitoring in labour. Drawing on online interviews and focus groups with 23 women in the UK, the study explored how IA is understood, offered and experienced during labour. Thematic analysis generated two overarching themes, “Choice takes work” and the “Impact of IA monitoring on the labouring woman”, highlighting that women frequently encountered limited information about fetal heart monitoring in pregnancy and labour and often had to actively seek out or negotiate their options. Participants described situations where IA was not offered despite guideline-based eligibility, as well as instances where IA was used without clear explanation of its purpose or alternatives.

The authors conclude that stronger, earlier antenatal communication and a more consistent approach to informed decision-making in labour could reduce practice variation and better support both women and midwives in navigating fetal heart rate monitoring choices.