Intrapartum fetal heart rate monitoring: do Swiss midwives implement evidence into practice?

Objective: Evidence Based Medicine has shown that the results of continuous electronic fetal heart rate (FHR) monitoring are equivalent to those of in termittent auscultation. We were interested in the method midwives preferre d to use to monitor FHR during labour and the factors which influenced thei r choice of method. Study Design: A questionnaire with Likert scaled questi ons was sent to 500 German speaking Swiss midwives. Data analysis was perfo rmed by using SPSS for Windows. Results: The majority of the midwives were confident monitoring FHR using intermittent auscultation as their main meth od during low risk delivery. The essential factors influencing the choice o f method of FHR monitoring were their own personal experience and hospital guidelines. Less important were factors such as risk category, litigation, the mother's preferences, research results, time and staffing levels. Concl usions: Although the skills necessary to implement evidence into obstetrica l practice are still available, evidence based research results do not seem to be of great importance, when midwives decide which method to use for in trapartum FHR monitoring. Hospital policies and the professional training r eceived were more important factors. Programs designed to implement evidenc e in care should reflect the identification and use of these factors in ord er to facilitate the process of realisation. (C) 2001 Elsevier Science Irel and Ltd. All rights reserved.