Personal Use of Handheld Fetal Doppler Monitors by Women in New Zealand

Lyndal Honeyman

doi:10.26686/wgtn.14132339.v1

Abstract

<div>This qualitative descriptive study explores what factors are driving women in New Zealand to use handheld fetal Doppler monitors during their pregnancy. This is a little explored phenomenon in the literature, and consensus among health professional bodies is that pregnant women should be discouraged from using a handheld fetal Doppler. One concern health professionals hold is that a pregnant woman may be falsely reassured about the condition of her unborn baby and would delay presentation to her lead maternity carer, culminating in stillbirth or neonatal morbidity and mortality that potentially could have been avoided.</div><div><br></div><div>Six women from a major New Zealand city who were between 20- and 39-weeks’ gestation participated in semi-structured interviews. Thematic analysis, as described by Braun and Clarke, was used to generate five main themes and six subthemes. Control was a strong overarching</div><div>theme with subthemes of Fertility and Pregnancy Loss, Ultrasound and Doppler anxieties. Fetal feedback with the subtheme of Bonding was another strong theme. The third and fourth themes were Peer-to-peer education and support and Lay knowledge versus professional knowledge with a</div><div>subtheme of Lack of research. The final theme was the Woman-Midwife relationship with a subtheme of More support.</div><div><br></div><div>Women’s reasons for using a handheld fetal Doppler is for control of their response to the potential of miscarriage. This response is largely one of anxiety, particularly prior to the quickening of the fetus when there is little feedback to prove ongoing fetal life outside of symptoms such as morning sickness. Whilst women gain their information to underpin use of a handheld fetal Doppler via their peer groups in online forums and other internet-based repositories, they are</div><div>wanting to enact partnership and shared decision-making with their lead maternity carer (LMC) regarding their use of handheld fetal Doppler monitors in pregnancy.</div><div><br></div><div>As technologies advance and become more available to non-health professionals, further exploration of use of handheld fetal Doppler monitors by pregnant women is needed in order to better inform women and midwives around the potential benefits and risks.</div>

Highlights

In the previous chapter, the research question was introduced:What factors are driving pregnant women to purchase or borrow, and use a fetal heart rate monitoring device? ; why they are choosing to use a handheld fetal Doppler, how they are using the device, and what information and supports underpin their decision-making.This chapter focuses on the literature reviewed throughout this thesis
This review focuses on literature for home blood pressure monitoring (HBPM) by pregnant women who have or are at high risk of hypertensive disorders during pregnancy
This study found that home blood pressure monitoring was clinically acceptable, with no difference in maternal, fetal, or neonatal outcomes compared to standard care, and a cost-saving per patient requiring monitoring, especially with support from the app developed for the study (Xydopoulous, et al, 2019, pp.500-501)

Summary

Introduction

The research question was introduced:What factors are driving pregnant women to purchase or borrow, and use a fetal heart rate monitoring device? ; why they are choosing to use a handheld fetal Doppler, how they are using the device, and what information and supports underpin their decision-making.This chapter focuses on the literature reviewed throughout this thesis. In using the handheld fetal Dopplers, women felt they could self-manage their anxiety during a period where there was no direct feedback from the unborn baby in the form of movement, and when midwife and ultrasound appointments were some weeks apart This control extended to managing the fear of the potential diagnosis of a repeat pregnancy loss diagnosed seen on the ultrasound scan, so that the women could allow themselves to feel a sense of enjoyment that they believe to be a reasonable response when attending a pregnancy scan. Known by a brand name as a sonicaid, is a device that utilises continuous wave ultrasound in order to auscultate a fetal heart rate during pregnancy, with the sound produced digitally via an in-built speaker or via headphone attachment These sounds are the reflection and amplification of the sounds of the fetal heart walls and valves as they move (Maude, 2019). Undertake an abdominal palpation...; Lubricate the Doppler ultrasound probe with a suitable conductive gel to facilitate ultrasound transmission; position the Doppler probe over the area where heart sounds are expected...; count the heart beat for 1 minute...; simultaneously palpate the maternal radial pulse to ensure it is the fetal heart that is being heard; reassure the woman about the other sounds that can be heard; wipe off gel with a tissue; discuss the results with the woman; document the time of listening, the device used, the fetal heart rate (as a single number), any other information obtained during monitoring, and a plan for follow-up (if required) (Maude, 2019, in deVitry Smith & Bayes, p.319)

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