Fetal Heart Rate Auscultation, 4th Edition.

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Evidence-Based Practice

Background:

• Intermittent auscultation (IA) is a recommended practice for fetal surveillance in low-risk pregnancies during labor.
• IA supports efforts to decrease primary cesarean birth rates and increase vaginal birth rates.
• The adoption of electronic fetal monitoring (EFM) has led to a decline in IA use and a rise in cesarean births.

Purpose of the Study:

• To provide comprehensive information on intermittent auscultation (IA) as a method of fetal surveillance.
• To support the implementation and effective use of IA in clinical practice.
• To highlight IA's role in promoting vaginal birth and reducing cesarean rates.

Main Methods:

• This practice monograph synthesizes current evidence and clinical guidelines.
• It covers IA techniques, interpretation, documentation, and clinical decision-making.
• The monograph also addresses communication, education, staffing, legal aspects, and implementation strategies.

Main Results:

• IA is an evidence-based method for fetal surveillance in low-risk labor.
• Decreased IA use correlates with increased EFM use and cesarean births.
• Effective IA implementation requires attention to technique, interpretation, and supporting factors.

Conclusions:

• Re-emphasizing and implementing IA is crucial for reducing cesarean rates.
• IA is a vital tool for promoting physiological birth and patient safety.
• This monograph serves as a resource for healthcare providers to optimize IA practice.