Electronic supplementary material
Sample (n = 11)
Age range (years)a
Maternity care setting
Maternal Fetal Medicine Clinic
Variables compared across scenarios
External fetal monitoring method
Two discs (transducers) rest on mother’s stomach, one disc measures heartbeat and other disc monitors contractions.
Internal fetal monitoring method.
Electrode inserted through woman’s vagina, and attached to unborn baby’s scalp. Lead is attached to mother’s thigh.
Only fetal scalp electrode can be used. Electrode inserted through woman’s vagina, and attached to unborn baby’s scalp. Lead is attached to mother’s thigh.
Movement during labour and contractions.
Abdominal belt: can stand, and move within a two-metre radius (length of cord connecting woman to monitor). Or, if using scalp electrode, must lay flat on bed.
Restricted mobility because need to be connected up to STan monitor. Mostly confined to bed.
Delivery associated with each technology.
Increased chance of operative intervention including caesarean section.
Decreased chance of operative intervention including caesarean section.
Risk and labour
…‘cos you never know [what] labour might be like (.) we all plan for you know ah good ah uncomplicated but you never know[010, 31–34, nulliparous, caseload midwifery].
…like I obviously I understand though that now everything is a lot more cautious and like careful like women don’t just have babies[01, 23–26, nulliparous, caseload midwifery].
I don’t want to feel like I never want to do that okay ((laughs)) like I don’t want to have anxiety about like you know ever having to have another baby ‘cos if you had like a traumatic birth[01, 23–26, nulliparous, caseload midwifery].
If, so I think I would have gone for monitor it’s never gonna hurt it’s just there….yeah it’s the reassurance[010, 31–34, nulliparous, caseload midwifery].
I: What is your immediate response to reading the two scenarios ((pause)) what most catches your eye?
P: Um they sound fairly similar um I would be apprehensive about having either[06, 31-34, nulliparous, maternal fetal medicine]
By contrast, another participant supported use of STan monitoring at the outset of labour, regardless of perceived pregnancy risk:So if it was a medical background there or medical reasons to have that additional monitoring then I would feel like it’s probably justified if it was just a everyone gets stuck to it I would probably think that it’s not necessary[011, 31-34, nulliparous, caseload midwifery]
Yeah I guess like this one [STan] in theory ‘kinda seems like better in the sense that it gives you a better idea of like if your baby is stressed[01, 23–26, nulliparous, caseload midwifery].
Perceived apprehension towards use of the scalp clip reflected uncertainty about internal monitoring:The CTG where it’s monitored on your stomach is fine but the clip attached to your baby’s head just for me personally is ((laughs)) weird[05, 31-34, parous, maternal fetal medicine]
Yeah it’s very scary sounding.[09, 23–26, nulliparous, maternal fetal medicine]
I’m not sure whether there would be particular risks associated with that it just seems a bit more invasive than might be necessary[011, 31–34, nulliparous, caseload midwifery].
You know you get examined so much it’s a standard thing when you get pregnant so this STan monitoring wouldn’t affect me in an invasive form[03, 23–26, parous, maternal fetal medicine].
Um one of the pros if there’s more information I guess that you get from going and putting the clip in like that ((pause)) it probably be something to look in to ((pause)) like if it gave you more information not sure what but yeah ((pause)) and I guess the other side would be like it’s pretty intrusive it’s pretty ((pause)) you’d wanna make sure that it’s safe while sticking the clip in and placing it[02, 35–38, parous, maternal fetal medicine].
...it’s a new technology so it might be able to get more information.[06, 31–34, nulliparous, maternal fetal medicine].
Have they even used this before?…nah I think I would be sticking to the CTG just because I guess this [STan monitoring] is new and trying something new probably for the first labour might be a little bit crazy[09, 23–26, nulliparous, maternal fetal medicine].
…like the baby moves and then it looses track of where the heart rate is with the CTG and I also have noticed a couple of times when I’ve had contractions the CTG doesn’t pick it up[07, 27–30, nulliparous, antenatal clinic].
Mobility in labour
You’d choose your baby’s health over you being comfortable any day…most mothers make that decision anyway[03, 23–26, parous, maternal fetal medicine].
Autonomy and choice in labour
I’m not one that gives opinions like that very often like I’d probably tell them about both and say what my choice was but yeah I’d obviously let them make their own decision[08, 31–34, parous, caseload midwifery].
This one [STan] was more invasive in the process that it’s inserted and it’s actually attached to the baby so I don’t know my point of view I’d like it all to be natural so at that stage when this little being’s coming into the world[08, 31–34, parous, caseload midwifery].
I think probably a negative of this one [CTG] is like you’d be in a rush to get your baby out…and there’s a more like a chance of like forceps and suction cups (.) like all the things that you don’t want ideally in the end ((laughs)) and I guess with that one [STan] you think they will slow your labour down and like give you a bit more of a chance to have things happen more naturally yeah less intervention[01, 23–26, nulliparous, caseload midwifery].
I guess no one really does talk about it to you get closer ‘til you get closer to the labour…that’s when they go through all the choices and you don’t know which one to do[04, 19–22, nulliparous, maternal fetal medicine].
You can’t make plans babies don’t stick to a plan… they do their own thing[07, 27–30, nulliparous, antenatal clinic].
Trust in maternity care providers
I’m a very doctors tell me to do something do that…they’re the ones with years of experience.[03, 23–26, parous, maternal fetal medicine].
It’s also about like being trusting with people that are working with you and trusting that they’re gonna take the right information from the monitoring and do like what’s best, ‘cos in my opinion there’s always gonna be doctors and midwives who are more inclined to say okay let’s intervene than ones that won’t[01, 23–26, nulliparous, caseload midwifery].