Assessment & Research

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

Brasted et al. (1984) · Journal of applied behavior analysis 1984
★ The Verdict

Let laboring women see the fetal monitor—they detect contractions sooner and breathe on time.

✓ Read this if BCBAs who teach childbirth classes or work in hospital parent-education.
✗ Skip if Clinicians who serve only pediatric or developmental-disability caseloads.

01Research in Context

01

What this study did

Researchers watched eight first-time moms in labor.

They turned the fetal-monitor screen toward the woman during some contractions and away during others.

The team timed how soon each mom said she felt the contraction start.

02

What they found

Six of the eight women noticed the tightening 2–3 seconds sooner when they could see the tracing.

Seven moms asked to keep the screen facing them for the rest of labor.

03

How this fits with other research

Chang et al. (2016) used an air-mouse on a student’s leg to give instant feedback for walking.

Both studies used ABAB reversals and showed that a simple tech cue can nudge behavior.

Ferreri et al. (2011) taught pedestrians to raise a hand so drivers would stop.

Like the fetal monitor, that prompt gave clear, immediate information and worked fast.

04

Why it matters

If you coach expectant families, show moms the monitor tracing.

That 2-second head start lets them begin paced breathing before pain peaks.

It costs nothing and most women want the screen left on.

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→ Action — try this Monday

During your next prenatal session, demo the monitor screen and have moms practice starting breaths the moment they see the contraction line rise.

02At a glance

Intervention
other
Design
reversal abab
Sample size
8
Population
neurotypical
Finding
positive
Magnitude
small

03Original abstract

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.

Journal of applied behavior analysis, 1984 · doi:10.1901/jaba.1984.17-261