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Women´s in childbed attitude towards cardiotocographical fetal monitoring during childbirth
PAPÍRNÍKOVÁ, Petra
Cardiotocography is a noninvasive method providing information on the condition of the fetus during pregnancy and childbirth. Fetal monitoring has become standard in obstetric care for pregnant women and mothers. The procedures recommended by the Czech Gynecological-Obstetrical Society determine indications of the use of cardiotocography and state rules of how to interpret the results of the method. During physiological childbirth the mother can be observed intermittently, i.e. at regular intervals according to the practice of the specific obstetric department. Pathological delivery, such as breech delivery, delivery of a hypotrofic fetus, fetus with a nonphysiological CTG record, should be monitored continuously. External fetal heart sounds scanning may bring mother some unpleasant restrictions in movement and positioning. When medical staff show preference in observing data obtained by monitoring, it may make the mother fear about the fetus´ condition or raise presumption that midwives do not adequately meet her own needs during the delivery. Nursing care of mothers during cardiotocographical scanning is very specific because a midwife provides care to two subjects - the mother and the child. According to scarce literature on this subject mothers{\crq} in bed attitudes toward cardiotocography vary from the positive view that monitoring protects the fetus and ensures its health to negative feelings of discomfort, limitations, pointless medialization of the natural process, medical personnel distraction and rejection of medical examination. Czech studies, however, have never been conducted and modern literature on this topic does not exist. The research was conducted by the prospective quantitative research using questionnaires. The questionnaires were anonymous and contained 26 questions, 23 of which were closed, 1 was semi-closed and 2 were open. The total number of questionnaires distributed was 101, the target respondents were women in confinement in the Gynecological-Obstetrical clinic of. 1. LF UK a VFN in Praque. The research database was composed of women who were 2 or 3 days after delivery, women with elective Caesarean section were not included into the research. The aim of the research was to learn women{\crq}s in childbed attitude toward cardiotocographical fetal monitoring during childbirth. Three hypotheses were stated: Hypothesis 1 assumes that mothers consider cardiotocographical fetal monitoring to be a source of information on the child condition, and this hypothesis was confirmed. Hypothesis 2 assumes that cardiotocographical fetal monitoring during childbirth restricts the mother{\crq}s movement and relief positioning, and this was confirmed by the research. Hypothesis 3 raises the presumption that there is a lack of valid information provided to mothers on cardiotocography, interpretation of CTG records and their relevance. This hypothesis was confirmed by the research. The women{\crq}s in childbed attitude toward cardiotocographical fetal monitoring during childbirth was evaluated and thus objectives of the thesis were met. Holistic approach in nursing care is supposed to ensure that all patients have access to the best possible comfort, comprehensive care and enough information. The conclusions of the research conducted in the Gynecological-Obstetrical clinic imply the need to improve communication and the flow of information from medical staff to women in childbed and technical possibility of CTG recorders.
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