Women's evaluations of their experience in a multicenter randomized controlled trial of intrapartum fetal pulse oximetry (the FOREMOST trial)

Abstract

ObjectiveFetal pulse oximetry improves the assessment of fetal well being during labor. We evaluated women´s satisfaction with their experience with this additional technology.Study designWe surveyed women participating in the FOREMOST trial, a randomized controlled trial comparing the addition of fetal pulse oximetry (FPO) to conventional cardiotocograph (CTG) monitoring (intervention group), versus CTG-only (control group), in the presence of non-reassuring fetal status during labor. Our survey evaluated three aspects of women´s experience: fetal-monitoring, labor and participation in the research. The survey was administered within a few days of giving birth and repeated three months later.ResultsThere were no differences between the intervention and control groups for women´s evaluations of their labor, fetal monitoring, research or overall experiences, when surveyed on the two occasions. Within each study group, there was a small but statistically significant decline in women´s scores for their experience of labor and overall experience from the initial survey close to the time of giving birth, to three months later. The magnitude of differences in responses over time was similar for the two groups. Women were more satisfied following a spontaneous or assisted vaginal birth than following cesarean section (Survey 1 p < 0.001, Survey 2 p < 0.001). Length of time the research midwife was present had a significant positive effect on women´s ratings of their experience several days after giving birth (p=0.006) but no effect at three months.ConclusionThe addition of fetal pulse oximetry for the assessment of fetal well-being during labor did not affect childbearing women´s perceptions of fetal monitoring or their labor. Women evaluated their experience in the research process positively overall. There were small changes in women´s perception of their satisfaction over time.