Reducing stillbirth by appropriate response to reduced fetal movements
Research type
Research Study
Full title
Reducing stillbirth by appropriate response to reduced fetal movements: evaluating midwives' and obstetricians' current knowledge and understanding.
IRAS ID
171494
Contact name
Rebecca Smyth
Contact email
Duration of Study in the UK
0 years, 11 months, 30 days
Research summary
Maternal perception of fetal movements has been used for many years as a method to evaluate fetal wellbeing. Pregnancies in which women consistently report regular movements have very low morbidity and mortality. Conversely, maternal perception of reduced fetal movements (RFM) is associated with adverse pregnancy outcome including stillbirth. In the UK about one baby in every 200 (who reaches 24 weeks’ gestation or more) is stillborn. As many as 50% of women perceive a reduction in fetal movements, several days before a stillbirth.
To this end, we recently completed a qualitative study exploring womens' and clinicians' experiences of RFM. The findings confirmed that women receive conflicting advice from their clinicians about RFM. In addition, the study identified clear knowledge deficits amongst clinicians; with significant variations in understanding of what constitutes RFM and uncertainty regarding management. Critically, there was evidence that conflicting advice led directly to delayed reporting / accessing of health care after experiencing RFM. We have no indication to believe that our findings are particular to our study site; rather they indicate a need to develop strategies to improve education for professionals and communication with women.
To more fully understand the issues surrounding clinical decision-making and professional practice in this area we plan to conduct focus group interviews with a sample of midwives (hospital and community based) and obstetricians (junior and senior) based at the local tertiary maternity unit (4 groups of 8-10 clinicians). We will explore with clinicians what impacts on their ability to understand and adhere to current national guidance. In addition, we will find out their preferred medium of information provision in order to identify appropriate educational training materials for clinical practice.REC name
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REC reference
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