|Questions to be addressed||Outcomes|
|1) Can women in labour be educated to detect changes in FHR (especially fetal bradycardia and fetal tachycardia) through self-monitoring of the FHR with a doppler monitor and alert the attending midwife?||1a) Number of women (out of all approached for consent) in two hospital maternity units willing to participate in the self-monitoring initiative|
1b) Number of women (out of all approached for consent) participating in the self-monitoring initiative who were able to detect FHR changes which were confirmed as abnormal and possibly harmful by the clinically attending midwife.
|2) Do attending midwives respond to alerts from women in labour regarding suspected FHR changes and do they initiate the agreed course of action (the birth asphyxia and stillbirth prevention protocol) every time in a timely manner?||2a) Number of times (out of all possible) an attending midwife responded to an alert from a participating woman in labour who self-detected a potentially harmful change in FHR.|
2b) Action taken by an attending midwife responding to an alert by a woman in labour of a possible FHR change and whether the agreed birth asphyxia and stillbirth prevention protocol had been followed.
|3) Did the labouring women find the experience of monitoring their unborn babies helpful?||3a) How many mothers found the monitoring helpful?|
3b) How many mothers found the monitoring difficult?
3c) How many mothers had to discontinue the monitoring?
|4) What measure could be implemented to improve the attainments of the above first three objectives and result in a sustainable programme?||4a) Improvements in obtaining consent|
4b) Improvements in the documentation of changes in FHR
4c) Feedback of results to the midwives on the maternity wards
4d) How to achieve sustainability given the temporary availability of trainee obstetric clinicians
|5) Was the attending midwife able to initiate an immediate course of treatment when she was alerted by a woman in labour who had identified changes in her FHR?|
6) Were professionals trained in advanced obstetrics and neonatal care able to provide effective treatment when asked to by the attending midwife?
|Treatments given and outcomes in the mother|
Treatments given and outcomes in the newborn infant