Obstetrician views on Fetal Pillow® device use and research in Aotearoa New Zealand: A cross-sectional survey

Aust N Z J Obstet Gynaecol. 2024 Apr 18. doi: 10.1111/ajo.13824. Online ahead of print.

Abstract

Background: There is anecdotal evidence of Fetal Pillow® use, but no formal local information on clinician practices and perspectives.

Aims: To assess obstetrician use of the Fetal Pillow®, knowledge of relevant research, and interest in a proposed randomised controlled trial in Aotearoa New Zealand.

Materials and methods: Anonymous cross-sectional survey of practising obstetricians and obstetric trainees in Aotearoa New Zealand distributed by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Results: Of 136 respondents (69% specialists and 31% trainees), 130 had heard of the Fetal Pillow® device, and 108 had used it at least once (43% more than ten times). The device was available in 17/21 units represented. The 108 users of the device reported this was most commonly on collegial advice (63%) or after personal experience of a difficult delivery (33%) and most (80%) believed it reduced maternal morbidity. Only around one-third of the 130 respondents who had heard of the device agreed there was adequate research demonstrating its efficacy for maternal (36%) and neonatal (30%) morbidity. The majority reported they would change practice in response to a randomised trial, although they were more likely to start use (81% of current non-users) than stop (53% of users). Most (70%) respondents agreed they would encourage patients to participate in a randomised trial.

Conclusions: The Fetal Pillow® is available in most maternity units in Aotearoa New Zealand. The majority of obstetric clinicians believe it reduces maternal morbidity, while acknowledging the lack of scientific evidence. Most would support a randomised trial.

Keywords: labour; maternal morbidity; neonatal morbidity; obstetrics; survey.