Helping student midwives become safe practitioners: effective teaching of cardiotocograph interpretation

The ‘Saving babies’ lives' care bundle identified effective fetal monitoring during labour as one of four key areas of care to reduce the number of stillbirths and early neonatal deaths in the UK (NHS England, 2016). Intrapartum cardiotocograph (CTG) interpretation is a key midwifery skill in which midwives must prove competency prior to registration and annually thereafter if caring for women in a birth setting (NHS England, 2016; Nursing and Midwifery Council [NMC], 2019). However, the most recent ‘Each baby counts’ report (Royal College of Obstetricians and Gynaecologists, 2019), which reviewed the care of women whose babies died or were severely disabled as a results of incidents occurring during term labour in 2017, found that CTG issues were a critical contributory factor in the care of 59% of cases in which different care may have affected outcomes. Similarly, the most recent perinatal confidential enquiry noted that ‘there were errors in the method, interpretation, escalation and response to fetal monitoring’ which were a contributing factor in several intrapartum deaths (Draper et al, 2017).