ABSTRACT
CARDIOTOCOGRAPHY the issues that distinguish the social model from the biomedical model of care: our relationship with birth technologies, the interpretation of equivocal evidence, notions of risk and the ecology of the birth environment. All these need exploring in the context of fetal monitoring. As I practise in a large consultant unit I experience exactly the same concerns regarding fetal monitoring now as I did when I was first prompted to write on this area in 1998. Since then I have had the opportunity to experience more births at home and in birth centres and these have informed my present views. One thing that is striking about environments where intermittent auscultation is used is how rarely fetal distress is diagnosed, when on large delivery suites it is a common occurrence. This is not explained solely by the different case mixes of each setting.
