Intermittent auscultation

Introduction

Listening to the fetal heart is an essential clinical skill that supports understanding fetal wellbeing. Listening can be carried out with a Pinard or a Doppler, both of which require different skills to use properly. Moreover, beyond counting a heart rate, a midwife needs to contextualise the heart tones in relation to the mother-baby context for what might be normal in one context may warrant emergency care in another context.  Therefore, midwives need to gather several sources of knowledge to synthesise to make interpretations that can impact mothers and baby’s outcomes. This study sheet assumes the reader has some knowledge and clinical experience of auscultating fetal hearts to offer some practice tips to developing this skill.

Learning aims and objectives

The aim of this study sheet is to improve your knowledge and understanding of the various skills required to complete intermittent auscultation. By the end of this article review study sheet you be able to:

– Understand why auscultation is carried out during labour/birth
– Understand the importance of intermittent auscultation (IA) as a core midwifery skill
– Explain the concept of ‘intelligent intermittent auscultation’
– Identify the clinical skills required to carry out effective IA

Keywords

fetal wellbeing, heart rate, intermittent auscultation, skill, competence

Curriculum quality standards

ICM Category 1; General Competencies

Lancet Series; Evidence informed framework for maternal and newborn care; evidenced based midwifery