Toolbox: Assessment of Fetal Well-Being

Resources and Tools

To show the list of resources and tools available within each category, click "Click to Expand" under the category subhead. Click on the icon to the left of the resource you wish to download or, in the case of a weblink, be taken to. You can also search our entire library of resources and tools by keyword, category or topic by going to our "Browse All' page

Improvement Stories

DocumentsQuestionnaire for Improvement Stories Highland
Highland Hospital joining the Reducing Primary Cesareans (RPC) Collaborative with a goal of implementing intermittent auscultation as appropriate to decrease their primary cesarean rate for low-risk women.

LinkFetal Health Surveillance: Switching to Intermittent Auscultation
The High River Hospital Community Maternity Program adopted new Fetal Health Surveilllance (FHS) guidelines on Intermittent Auscultation (IA) in appropriate situations that matched their Low Risk program and philosophy.

LinkIncreasing Use of Intermittent Auscultation for Low-Risk Laboring Women
Oregon Health Sciences University (OHSU) Midwives increase use of intermittent auscultation for low risk laboring women.

Audit Tools

DocumentsAssessing Fetal Well-Being Audit Tool
Measure and track your progress using evidence-based process and outcome measures with this audit tool.

Model Policies

DocumentsAHS FM Policy
This model policy for intrapartum fetal monitoring from Alameda Health System can be used to guide your practice with the institution of intermittent auscultation to promote physiologic birth.

DocumentsModel Policy for Fetal Monitoring-Denver Health
Model policy developed to help monitor maternal status throughout labor and monitor the fetal heart rate to assess fetal well-being if greater or equal to 24 weeks gestation. Developed by Denver Health, March 2006.

DocumentsIntermittent Auscultation Guideline-UNM
Guidelines to help assess good candidates for Intermittent Auscultation for fetal surveillance during labor. Developed by UNM.

DocumentsModel Policy for Fetal Monitoring- Zuckerberg SF General Hospital
The purpose of the policy is to provide guidelines for fetal monitoring and uterine contraction assessment and documentation in the Birth Center. Created by the Zuckerberg San Francisco General Hospital.

DocumentsIntermittent Auscultation of Fetal Heart Rate- Denver Health
Denver Health Clinical Care Guideline: Intermittent Auscultation of the Fetal Heart Rate (also includes Algorithm) Powerpoint presentation.


DocumentsUMMC Checklist for Eligibility of IA
This checklist for eligibility of IA, developed by the team at the University of Minnesota Medical Center, ensures that IA is only used for proper candidates, promoting safety.

DocumentsHighland Hospital Triage Labor Evaluation Algorithm
This algorithm, developed by Highland Hospital, can be used in the triage unit to determine if intermittent auscultation or continuous electronic fetal monitoring is most appropriate for the assessment of fetal well-being.

DocumentsAntenatal Outpatient Assessment Form
Antenatal outpatient assessment form that has the criteria for IA and continuous fetal monitoring right on the form. Provided by Calgary Health Region.

Clinical Education/Staff Training Resources

LinkUMMC IA training video
This video, developed by a DNP student at the University of Minnesota Medical Center, walks through the proper steps of performing intermittent auscultation safely.

DocumentsDoppler IA Pack
This photo is an example of a “Doppler IA Pack” used by Highland Hospital, including laminated “cheat sheets” to assist nursing staff with utilizing intermittent auscultation.

DocumentsSafe Beginnings: Implementing IA as the Standard for Low-Risk Women
This presentation reviews the process of implementing intermittent auscultation as the standard for low-risk women to decrease the primary cesarean rate in a hospital setting.

DocumentsMaking IA the Norm in the Hospital Setting
Moving Evidence Into Practice: Making Intermittent Auscultation the Norm in the Hospital Setting, presented by staff CNMs from Oregon Health & Science University at the presented at ACNM's 59th Annual Meeting. A PDF of the presentation with notes.

Patient Education

DocumentsChoosing Wisely: Fetal Monitoring
A resource for women about the options for fetal heart rate assessment during labor.

Position Statements/Related Guidelines/Toolkits

LinkFetal Heart Monitoring Principles and Practices Fifth Edition
This practice monograph describes how to perform fetal heart rate auscultation and discusses the benefits and limitations of intermittent auscultation (IA). Published by AWHONN.

LinkIntermittent Ausculation for Intrapartum FHR Clinical Bulletin (ACNM)
Link to PDF of the ACNM Clinical Bulletin: Intermittent Auscultation for Intrapartum Fetal Heart Rate Surveillance. This clinical bulletin reviews how to perform and interpret intermittent auscultation and provides evidence-based information about patient selection for IA.



© American College of Nurse-Midwives | 8403 Colesville Road, Suite 1550, Silver Spring, MD 20910-6374 |