Roxanne Anderson, LM CPM IBCLC : Midwife & Lactation Support, DFW

11/06/2025

The fact is that continual fetal monitoring has never been proven to improve outcomes

An excellent article today from . Note the lack of evidence supporting the use of continuous fetal monitoring, the clear influence of business and economics, and the money grab from AI companies who claim studies support their product - when in fact they don’t - resulting in remote monitoring hubs.

I especially love that placenta accreta is described early in the article so the public can see that cesareans carry risk. As a result, we need to ensure that they occur only when needed or wanted.

Note that the photo for this article is of a remote monitoring hub. One such hub is up to 60 miles away from the hospital in which the woman is laboring.

“Nearly every woman who gives birth in an American hospital is strapped with a belt of sensors to track the baby’s heartbeat. If the pattern is deemed abnormal — too slow, for example — doctors often call for an emergency C-section.

But this round-the-clock monitoring, the most common obstetric procedure in the country, rarely helps baby or mother. Decades of research have shown that the tool does not reliably predict fetal distress. In fact, experts say, it leads to many unnecessary surgeries as doctors overreact to its ever-changing readouts.

The obstetrics field has long ignored these problems. Now, it’s putting more trust than ever on the flawed technology, often prioritizing business and legal concerns ahead of what’s best for patients, The New York Times found.

This fall, the American College of Obstetricians and Gynecologists updated its guidelines on continuous monitoring, sanctioning it even as some other wealthy countries have cautioned against its routine use…

All three remote hubs, along with 400 other hospitals around the country, use A.I. software to help analyze the heart data. The software’s maker, PeriGen, has claimed on its website that 50 studies backed up its products.

But none of the studies found that the technology improved birth outcomes. PeriGen removed the list of studies after an inquiry from The Times. The company’s chief executive, Matthew Sappern, acknowledged that no clinical trials had shown benefits.”

https://www.nytimes.com/2025/11/06/health/electronic-fetal-monitoring-c-sections.html?unlocked_article_code=1.zE8.145f.FPhFANzFoVZp&smid=nytcore-ios-share&referringSource=articleShare

08/15/2025

Midwife news!
First a little backstory:
The North Texas Midwives Association is a organization uniting midwife professionals in the DFW area. Membership is open to licensed midwives and students. NTM encourages members to participate in a spirit of humility, responsibility and accountability as we work to ensure the future of midwifery in the state of Texas.

I became a member of NTM back in the 1980s- yes it has been going that long! It was a place to hang out with other midwives, get the news, learn, grow and support each other. We've been through some ups and downs over the years, but this year has been an unique one, and it has brought many midwives back to our meetings. We had gone to quarterly meetings while things were slow, but we are now back to meeting the second Wednesday of each month except December and May.

If you are a midwife or a midwifery student and used to be a member or never got around to being a member, we'd love to have you! You can come check out our meetings with no obligation- we are inclusive not exclusive and love to meet more of our colleagues in the area.

What makes NTM special is we are a member based, member driven group- EVERY member has a voice and a vote, and is able to speak freely in our meetings.

Just as a sample, this is what we talked about at the meeting this week:

So excited to recap and follow up with North Texas Midwives (NTM) plans for data registry, specifically CBDR- Community Birth Data Registry.

What is cool about this registry is that it is under the same parent organization (FHCQ) as Smooth Transitions and designed to interface with it. We had a great presentation earlier this month on that from Carla Morrow. And the sample data she shared? That was from the CBDR stats from home birth midwives in WA.

(FHCQ is a non-profit, neutral entity that houses a suite of programs centered around quality improvement and patient safety.)

Another cool thing is that they also house the companion data collection program OB Care Outcomes Assessment Program (OB COAP). This program is essentially the hospital component of the CBDR also designed to interface with Smooth Transitions.
Which means if hospitals sign up with Smooth Transitions, that's another step toward encouraging them to collect exactly the same data points we will be collecting, making comparisons of outcomes apples to apples.

CBDR offers groups of midwives who wish to participate better prices than individuals, so NTM is currently discussing how to make this an opportunity for our members, and getting all the details some of which were shared at this month's meeting.

And why data entry anyway? Well, as we have all been hearing and discussing, this is an important step for us as Texas midwives to get accurate picture of our statistics in order hold ourselves accountable to appropriate standards of care. It is anticipated that this may be mandatory at some point in Texas as it is in WA- and this was the program designed to meet that need.

Currently there are two national data birth registries that collect date from home and birth center births, and they are the CBDR- which I have just described, and the PDR- Perinatal Data Registry. https://www.nacpm.org/data-collection-for-cpms
https://www.qualityhealth.org/cbdr/about-cbdr/
https://www.birthcenters.org/pdr

The American Association of Birth Centers is having a virtual informational meeting on Monday 18th about the PDR. In the same way that NTM is seeking to provide an easier entry to CBDR for its members, AABC offers its members a discount on AABC participation.

I was drawn to the CBDR both because it is more cost effective for small practices, and also because it interfaces with Smooth Transitions.

NTM members, please plan to attend the September meeting to have a voice in our decision making! We are working hard behind the scenes to be past the discussion stage to the voting stage at that time.