Midwives’ perceptions on using a fetoscope and Doppler for fetal heart rate assessments during labor: a qualitative study in rural Tanzania
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Date
2018
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Journal ISSN
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Publisher
BMC pregnancy and childbirth
Abstract
Background: The Doppler is thought to be more comfortable and effective compared to the fetoscope for
assessing the fetal heart rate (FHR) during labor. However, in a rural Tanzanian hospital, midwives who had easy
access to both devices mostly used fetoscope. This study explored midwives’ perception of factors influencing their
preference for using either a Pinard fetoscope or a FreePlay wind-up Doppler for intermittent FHR monitoring.
Methods: Midwives who had worked for at least 6 months in the labor ward were recruited. Focus group discussion
(FGD) was used to collect data. Five FGDs were conducted between December 2015 and February 2016. Qualitative
content analysis was employed using NVivo 11.0.
Results: Three main themes emerged as factors perceived by midwives as influencing their preference; 1) Sufficient
training and experience with using a device; Midwives had been using fetoscopes since their midwifery training, and
they had vast experience using it. The Doppler was recently introduced in the maternity ward, and midwives had
insufficient training in how to use it. 2) Ability of the device to produce reliable measurements; Using a fetoscope, one
must listen for the heartbeat, count using a watch, and calculate, the Doppler provides both a display and sound of
the FHR. Fetoscope measurements are prone to human errors, and Doppler measurements are prone to instrumental
errors. 3) Convenience of use and comfort of a device; Fetoscopes do not need charging, and while it is possible to
“personalize/hide” the measurements, and may be painful for mothers. Dopplers need charging and do not cause pain,
but provide limited privacy.
Conclusion: Midwives’ preferences of FHR monitoring devices are influenced by the level of device training,
experience with using a device, reliable measurements, and convenience and comfort during use. Fetoscopes and
Dopplers should be equally available during midwifery training and in clinical practice.
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Keywords
Midwives, Fetoscope, Doppler
Citation
Mdoe, P.F., Ersdal, H.L., Mduma, E., Moshiro, R., Kidanto, H. and Mbekenga, C., 2018. Midwives’ perceptions on using a fetoscope and Doppler for fetal heart rate assessments during labor: A qualitative study in rural Tanzania. BMC pregnancy and childbirth, 18(1), pp.1-10.