Training and support for IA
This section provides guidance and resources designed to build and maintain IA skills, expertise and confidence in IA practice.
Why is this important?
Intermittent auscultation is a core midwifery skill – often referred to as midwifery ‘bread and butter’ - but there is currently no national standard for IA training or competency assessment. To ensure IA is used safely and consistently, and to build confidence, midwives need regular training, practice support, and opportunities to practice IA. It is also essential that the wider multi-disciplinary team, understands and values IA skills.
What Listen2Baby found
The national survey of IA practice marked variation in the type of IA training package used. We also observed the following as supporting midwives to develop confidence, and maintain and practice IA skills:
- Multi-disciplinary leadership that values IA as a skill
- Fetal monitoring training that includes IA underpinned by fetal physiology
- IA training for resident doctors and consultant obstetricians
- Mentoring from experienced midwives
Regular holistic wellbeing checks for the woman, baby and midwife during labour.
Next Steps
Based on the above, we recommend:
- Review your IA training
- Ensure mandatory fetal monitoring training includes IA, underpinned by fetal physiology
- Ensure that the whole MDT, including resident doctors and obstetricians, receive training in IA
- Ensure that midwives are supported to count the FH with the method that they feel most confident using
- Include training about who should be offered IA
- Consider role play training about talking with women about monitoring
- Ensure IA cases are covered in weekly monitoring meetings or other educational discussions
- Review the support provided to strengthen IA practice
- Introduce a mentoring model for IA practice support
- Introduce holistic peer review for woman, baby and midwife
- Ensure that staffing models support:
- A second midwife attending during the second stage of labour
- Senior midwifery support for IA
Training resources
Making the case for IA
Listen2Baby IA and fetal physiology training videos
Introduction to IA and fetal physiology
Intrapartum fetal physiology Unit 1
- Calculating a fetal heart baseline and making sense of it;
- Fetal adaptations to stress in labour;
- Accelerations and decelerations and how to make sense of them;
- Initial assessment of the fetus.
Intrapartum fetal physiology Unit 2
- How is the fetus?;
- Bringing in the clinical picture; summary and reflections; further reading
This study is funded by the National Institute for Health and Care Research (NIHR)