An evaluation of the electronic fetal monitor as a feedback device during labor.

We describe new methodology for the evaluation of the labor experience and preliminary findings using these methods. The effects of feedback from an Electronic Fetal Monitor on report of contraction onset were evaluated during the labors of eight primiparous women, four of whom had attended childbirth preparation classes. Using a within-subject reversal design, data were gathered across four phases for each woman: no feedback (monitor turned away from mother and coach), feedback, no feedback, and feedback again. The women were observed in early labor without medication. Six women were able to note the onset of contractions earlier with the availability of feedback; two women (who had not attended childbirth preparation classes) were more variable in their response. Threshold for recognition of pain onset did not change reliably. Seven of the eight women chose to continue monitoring when offered the chance to discontinue it. These results suggest that the technological advance of fetal monitoring can be used in cooperation with prepared childbirth techniques to facilitate earlier recognition of contraction onset, allowing increased preparation for contractions. Further experimental evaluations during labor are suggested.