A big thank you to all those nurses working in hospitals who are willing to speak out about this evil.
The WORST Idea Since Routine Continuous Fetal Monitoring For Low Risk Mothers
My husband (being the techie cutie that he is) reads CNET news, a website about computers, the Internet, and groundbreaking technology as part of his morning routine. The other day, while I was enjoying my Kashi cereal and checking out the latest blog posts on my Google Reader, my husband hollered over to me from his office and said,“Hey Melissa, have you heard of LaborPro?” Until that moment I was having a pretty good Sunday morning. I mean, I woke up refreshed and smiling, the sun was shining, and I was looking forward to what I felt was going to be a “good” day at work. But my attitude quickly turned from happy-go-lucky to blinding rage when he uttered those eight little words.
(Okay, okay, so I think I am being a bit dramatic. Maybe blinding rage is a bit strong. But I was pretty upset!!)
So what is LaborPro and why did it put me into such a tizzy you ask? According to Trig Medical’s website (the Israeli company [emphasis added] that is developing and recently won a Frost & Sullivan Technology Innovation of the Year Award for this GARBAGE), LaborPro is “a novel labor monitoring system that using ultrasound imaging measures continuously and objectively fetal position, presentation and station along with cervical dilatation. LaborPro quantitatively assesses and records vital labor parameters in real-time to enable obstetricians to make informed and accurate decisions throughout the labor process to improve both the quality and cost of obstetric care.”
Photo Credit: http://www.trigmed.com/index.php
The website lists LaborPro’s capabilities as able to:
* Determine continuous station & position of fetal head by ultrasound imaging,
* Provide radiation-free pelvimetry & birth canal modeling.
* Perform one-step computerized “non-invasive” trans-vaginal digital examination (I’ll touch on that in moment)
* Determine intermittent or continuous accurate measurement of cervical dilatation
* Record comprehensive labor data recording
It also touts its “unique benefits” as the following:
* Non-invasive, precise measurement of station & position
* Improves assessment of non-progressive labor
* Supports decision-making before operative delivery
* User friendly, on-screen display of all labor parameters
* Enhances patient comfort and sense of security
Okay okay okay….Just HOW does it do this you ask? Well it’s EASY! (*rolling eyes*) Well according to the website’s one mintute educational video (check it out here, it’s worth it). FIRST you have to place “just four little electrodes” externally on the mother’s pelvis in order to continuously assess fetal station and position and also enables the user to “recognize CPD early”. SECOND you just have to clip (or screw) “just a few position sensors” to the woman’s cervix to accurately and continuously measure cervical dilation. And THIRD you just have to screw “just a small little electrode” into the baby’s head.
Close up of a fetal scalp electrode, or FSE (notice the little corkscrew tip, that screws into the baby's scalp.)
According to Frost & Sullivan, the organization that awarded Trig Medical for the LaborPro technology writes, “The LaborPro is staff and mother-friendly and requires only basic training in ultrasound usage, obviating the need for an obstetric ultrasound expert,” adds Ms. Prabakar. “Moreover, the technology employs non-invasive, radiation-free pelvimetry as well as a single-step computerised digital examination. All labor progress tracking data including the fetal heart rate monitor are integrated in the LaborPro display and automatically recorded by the system, which helps reduce staff workload.”
Oh great! We only need “basic ultrasound skills” to work it! (*double eye rolling*) Here’s a novel idea! How about every hospital (including my own) in the United States that has a L&D floor actually provide labor support training to their nurses instead! That would go a lot farther for us than freaking ultrasound skills!!
(Just for the record, my hospital does NOT include labor support training as part of orientation and we are NOT alone. At my hospital, if you want to learn how to provide labor support you have to seek out other learning opportunites on your own, like I had to. But we do get extensive training on how to work and interpret the fetal monitor. Oh and about 1/3 of our three month orientation is dedicated to learning how to care for a patient who is being induced. In fact, I had to teach myself how to do intermittent auscultation and hence, I am one of the only nurses that I work with that isn’t “scared” of intermittent auscultation and will actually advocate for it!)
The most terrifying thing is that although at this time LaborPro is not available in the United States (Oh Hallelujah!!!) there is another company called Barnev based out of Andover, MA [Barnev is also an Israeli-based company - Barnev Inc., 8 Hamelacha Street P.O. Box 8694. Netanya 42504 Israel Phone: 972-9-89231-30*] that has developed an almost identical product they call BirthTrack™ Continuous Labor Monitoring System which they describe as “a revolutionary continuous labor monitoring technology that provides obstetric caregivers invaluable, precise, objective, real-time information about the physical progress of labor. The BirthTrack System provides tools for a more informed decision making process through which hospitals can reduce the risks and costs of childbirth and assure the safety and comfort of mothers-to-be and their babies.” I remember hearing about this product a couple of years ago when it was still in “development.” Well guess what?! Development is over!! Marketing here we come!! (GAG me!)
So now there are at least TWO companies that are actively marketing this HORRIFIC, INHUMANE, and OUTRAGEOUS product. Just wait until LaborPro makes it to the United States (which according to their website they are actively persuing). Then they will probably start to compete with eachother! Now now only will labor & delivery wards around the country have to deal with Similac and Enfamil representatives competing for our money and attention in house (which already makes me sick to my stomach), but now I have to worry about this??!! THIS IS TERRIFYING!!!
I’m telling you right now, I will UP AND QUIT my job and never look back if either LaborPro or BirthTrack EVER appears in even just one, JUST ONE of my hospital’s labor rooms. QUIT ON THE SPOT! And I will make a Hollywood exit too! A HUGE scene!!! Hooting and hollering! You just wait!! LOL! As if our moms aren’t already strapped down enough with the often unnecessary and sometimes downright harmful technology we already have. This is just TOO MUCH TO BEAR!
I have taken care of MANY a laboring woman (often as a result of an induction, mind you) who are connected to:
(1) an IV line with IV fluids and Pitocin running through,
(2) an electronic fetal monitor to measure fetal heart rate,
(3) a tocodransducer to measure contraction pattern
(OR a fetal scalp electrode to measure fetal heart rate and an intrauterine pressure catheter to measure contraction frequency and strength),
4) an epidural catheter in the back giving a continuous flow of anethetic and narcotic medications into the spinal column,
(5) a foley catheter in the bladder since it is very rare that one can empty their bladder with an epidural,
(6) a pulse oximeter to continuously measure blood oxygen level (necessitated by the epidural),
(7) a blood pressure cuff to record one’s blood pressure every 15 minutes since an epidural can drop your blood pressure dangerously low, and finally
(8) if the baby has shown any signs of distress, an oxygen mask for your face!
Well I have a message for both Trig Medical and Barnev, LABORING WOMEN DO NOT NEED ANY MORE THINGS SHOVED UP THEIR VAGINA!!!! And furthermore, CLIPPING ANYTHING TO A WOMAN’S CERVIX OR SCREWING ANYTHING INTO A BABY’S HEAD DOES NOT COUNT AS “NON-INVASIVE”!!! LABORING WOMEN AND BABIES ARE NOT ROBOTS THAT DON’T FEEL ANY PAIN OR DISCOMFORT!!!! RESEARCH HAS SHOWN TIME AND TIME AGAIN THAT LESS IS MORE WHEN IT COMES TO LABOR FOR HEALTHY MOMS AND BABIES!!! CONTINUITY OF CARE IS MUCH MORE EFFECTIVE, LESS PAINFUL, LESS INVASIVE THAN ANY “COMPUTERIZED FINGER.”
Furthermore, LaborPro and BirthTrack are a slap in the face to every labor and delivery nurse that cares about giving appropriate, effective, competent, physiological, and compassionate care to childbearing families. Unfortunately I would bet my hard earned money that at least half of the doctors I currently work with would think that this is a good idea.
Okay, okay, now that I am all riled up again I have to go to work :( Please check out Rixa’s post over at Stand and Deliver about BirthTrack. It was written about a year ago and I stumbled upon it when I was searching for a picture of a fetal scalp electrode!!
Change has GOT to come! It’s GOT to! For the health and wellness of our mothers and babies!! Remember ladies, YOU actually have more power than ME and all the other L&D nurses out there!! That’s right! If you do not hire birth attendants that do not support evidenced based medicine and physiological birth and do not patronize hospitals that do not support a family-centered approach to maternity care then and only then will they start to listen. You know why? Because when the customers aren’t comin’, it hits them where it hurts… in their WALLET!!
* Please Note: Barnev Ltd. received R&D grants from the Office of Chief Scientist of Israel (OCS), totaling approximately 7.35 Million New Israeli Shekels, equivalent to about $2.0 million in current U.S. Dollars according to this link.