I will introduce the methodology of cardiotocography, the machinery involved in monitoring babies during labour and sometimes in pregnancy. Although I shall concern the research I am sharing with labour alone, I will highlight the gruesome application in general. I will then go through the possible risks associated with this highly invasive technology. I will provide the evidence that suggests long-lasting physiological and psychological effects after pain is suffered when in infancy. I will end showing the opinions of the pioneer of invasive births, the Jewish Dr. Joseph DeLee whose shocking techniques were used on mass.
Cardiotocography is a fetal monitoring system that can be external or internal. If used externally, it can cause discomfort to the mom and incur more interventions for the baby. The external monitor gives massively inaccurate readings, which could lead to internal readings then being monitored, which claim to have a more accurate reading; more accurate than a really bad one anyway. A big concern is that the readings coming from the machines are incorrect, making them useless.
A massive 85% of US women are monitored using cardiotocograohy during labour (Essential Medical Facts Every Clinician Should Know, Taylor, 2011). Those women should be aware of the side effects of such interventions.
The reason for using this technology is to monitor the heart rate of baby and show any signs of foetal hypoxia insults, which means the deprivation of an adequate supply of oxygen. The machine normally only gives a heartbeat reading, and from this assumptions about oxygen levels are made. There is a catheter that can be attached to monitor the pressure of the uterine contractions, but is rarely used.
The causes for concerns, which lead to constant monitoring, are shown in the purple slide (click to enlarge).
External monitoring involves a machine strapped to the stomach of the woman in labour, taking continuous readings, of which there are many, often making the information hard to decipher. Foetal scalp electrode monitoring is when an electrode is put into the womb through the cervix and clipped, screwed, or hooked onto babies head, taking information on the baby’s heart beat and any variables shown. It seems that if anyone gets a hook in the head they may just have an increased heartbeat anyway, making this perhaps counter-productive.
You can look up any pain with increased heartbeat and you will learn that “your heart will respond in a reflexive manner to the pain by increasing heart rate.” (Livestrong)
So maybe, just maybe this entire process taking readings that show stress levels, is actually causing increased stress because of the environment the poor baby is being born into. Oh my god, do we have no sense?
“Internal monitoring is performed by attaching a screw-type electrode to the fetal scalp with a connection to an FHR monitor.” (American family physician).
However, the machine and the practitioner often misread the data and then alarm bells ring, more interventions are introduced, and a previously unstressed mom and baby are now in distress. Or maybe they are not in distress, who knows, as these graphs are so hard to read.
“One major risk of any type of fetal monitoring is the presence of false positive and false negative results. A false positive result is when the information is interpreted as indicating distress but there is no fetal distress.”(Healthline, 2012).
So how common is a false reading and does this make them totally worthless?
“Abnormal FHR patterns in continuous electronic fetal heart monitoring are sometimes a difficult problem for the attending obstetrician because of the high false- positive rate. Overestimation of danger to the fetus is of common occurrence.” (Manual of Obstetrics, 2005,pg387)
This false positive reading then shows the foetus is in distress, when it is not in the kind of distress they are looking for. There is a massive increase in caesarean sections, vacuum and forceps-aided deliveries. The side effects of such interventions and assistance causes;
“FSE was used in 37,492 (22%) of deliveries and was associated with increased risk of subdural and cerebral hemorrhage, injury to scalp due to birth trauma, cephalohematoma, jaundice, asphyxia, and sepsis (TABLE). In a secondary analysis, FSE + VAVD was associated with a substantially higher risk of composite trauma including scalp injury, subdural and cerebral hemorrhage, subgaleal hematoma and cephalohematoma” (American Journal of obstetrics and gynecology, 273: Complications associated with fetal scalp electrode, Tetsuya Kawakita et al, 2015)
Let’s go through these potential dangers and find out what FSE (Fetal scalp electrode) is causing:
‘cephalohematoma’ is a pool of blood underneath the skin from damaged blood vessels, causing anaemia (Iron deficiency).
The cephalohematoma can cause ‘Jaundice’, which is common for most infants, as their livers are not mature this will normally self-correct as the baby ages. However, jaundice is also a warning sign for underlying problems, such as ‘Sepsis’ which is an infection;
“Sepsis is a life-threatening illness caused when the body is overcome by infection. It is often called septicaemia or blood poisoning when the body is fighting a severe infection that has spread via the bloodstream.” (WebMD).
When a person has septicaemia his or her body will go into immune overdrive and release many white blood cells. The body will become weak after swelling. Eventually there will be a deficiency in oxygen.
Asphyxia is intended to be reduced by FSM, but can also cause it. Asphyxia is a lack of oxygen to the brain and can lead to suffocation.
Scalp Injury is the most frequently caused complication with using the FSE but can be extensive and one hospital decided to review standards of practice after a literary review and their hospital experience showed “severe scalp laceration due to a scalp electrode.” (Expert Review of Obstetrics & Gynecology ,Volume 8, Issue 2, Pieter Folkert de Groot et al, 2013)
Subdural haemorrhage is when blood is collecting between the skull and the surface of the brain and applying pressure to the brain this can cause unconsciousness and fatality. Cerebral haemorrhage is when there is bleeding within the brain, and surgery is required if extensive. Bleeding within the brain causes the death of cells, and carries high risk of fatality.
Other reports using continuous CTG machinery showed that the patients without CTG had lower cerebral palsy in infants, those with continuous had higher rates. (Intervention Review, Zarko et al, 2013)
It concerns me that once upon a time doctors used skills, skills that they are no longer taught. Midwives are scared of trusting themselves and rely heavily upon machinery. Although the NICE (National Institute for Health and Care Excellence) guidelines state that women must be with a midwife and a monitor simultaneously, and that monitoring is not to do the job of the midwife, many women can be left alone and monitored from an adjoined pc, showing several monitors at once to a practitioner observing.
So we willingly hurt babies; are there any long lasting damages for the newborns, which have suffered a painful birth and are born with lacerations all over their heads?
“Physiologic studies in animals indicate that very early pain experiences may have more than immediate consequences in infancy. Ongoing lowered pain thresholds in the injured area indicate that changes occur in the still-developing spinal cord. Early stress may lead to a reduced immune system response, resulting in consequences such as delayed wound healing and potentially an increased susceptibility to infection. Increased pain sensitivity, decreased immune system functioning, increased avoidance behavior, and social hypervigilance are all possible outcomes.”(Journal of Perinatal Education, Are There Long-Term Consequences of Pain in Newborn or Very Young Infants, 2004)
This concludes that changes in the central nervous system occur as well as psychological trauma, leading to avoidance behaviors. In other words, weakness. Traumatising the young may cause a mass future populous that does not protect themselves or others; they will avoid conflict by fleeing and perhaps freeze still in shock when seeing a situation in which one should act. Like the ‘bystander effect’, people passing other people in danger and doing nothing to help. Social hypervigilance is a hypersensitivity that leads to an anxiousness, which the person is on constant threat alert, which may cause inappropriate or aggressive behaviours. We’re creating a world full of angry or/and passive people, with erratic behaviours who cannot socialise well… actually, that’s what we already have. But birth didn’t do you any harm, I hear some say. Really? Because most of us are barely functioning, with a massive aversion for responsibility and a desire for escapism. This is just where they want us to be, distracted and weary.
Dr. Joseph DeLee was an early advocator of interventions in labour. He aided the change of childbirth from a normal process to one that has become only clinical, and viewed as a medical condition. Dr. Joseph DeLee advocated unconscious and drugged labour with forceps intervention as a delivery method for all. It is a slight twist on the take of ‘twilight sleep’, which endangered many; it was highly publicised as ‘painless birth’ with blissful outcomes, and with this propaganda it aided the shift of women willingly into hospitals, the delusions during labour, and of course the cages used to hold hysterical women were not publicised.
DeLee believed that avoiding damage during labour is unlikely, that all labour causes tears and rips, and that a woman was pretty bad at birthing. This Jewish ‘father of modern obstetrics’ introduced detached maternity wards and promoted hospital births as being the safest option, although mortality rates remained for baby and increased for mom.
“Maternal mortality rates were highest in this century during 1900-1930 (2). Poor obstetric education and delivery practices were mainly responsible for the high numbers of maternal deaths, most of which were preventable.” (CDC, 1999)
As the hospital births increased, then theoretically if DeLee was correct, the numbers of mortality should have decreased, but they did not and his defence was uncleanliness. I agree with him fully that sanitation is a correlating factor to ensure healthy births, but he cannot shake that his interventions where harmful.
He wrote on his views of labour: “Labor is pathogenic, disease producing, and anything pathogenic is pathological or abnormal… I have often wondered if women should be used up in the process of reproduction, in a manner analogous to that of salmon, which dies after spawning.” (Dr Joseph DeLee, The Prophylactic Forceps Operation)
Luckily he is incorrect as I am living proof of humans being able to birth more than one or two generations and be able to point out that he is stupid!
So this lovely individual who continued hospital suffering, by strapping women to a bed, giving them Morphine and Scopolamine, rendering them unconscious, removing their baby with forceps then stitching them up in the hope that they would, “abolish the memory of the labor as much as possible” (Dr Joseph DeLee, The Prophylactic Forceps Operation).
Before his death he claimed his techniques were not to be mass used at the time of his papers, as there were not enough competent practitioners. If I write down the ingredients to make a cake I created, with step by step instructions, and then publish this in the bakery world and deliver it to the hands of bakers directly, I may have to come to the conclusion that bakers will bake the fricking cake!
It appears there have only been minor changes since then. Women are still drugged up, strapped to a bed and very often forceps are used. Long gone are the leather straps to tie women down, but now we have an even better method, in which women fear for the life inside of them and are having machinery willingly strapped upon them. We no longer kick and fight, we just lay down in dangerous trust… what was that I said about avoidance behaviours?
I would like to add another article at a later date and delve into twilight sleep and the beginning of the birth of maternity and obstetrics in hospitalisation itself, as the main purpose of this text was to discuss the side effects of invasive monitoring.