Intelligent Intermittent Auscultation in Labour – elearning for healthcare
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This programme is in partnership with...
  • Oxford University Hospitals NHS Foundation Trust
  • Oxford Academic Health Science Network - Partnership logo

About Intelligent Intermittent Auscultation in Labour

Aims and ambitions

Intelligent Intermittent Auscultation (IIA) of the fetal heart is the recommended method of fetal monitoring for all women who are considered at low risk of fetal hypoxia during labour. It is therefore a fundamental skill of all midwives in any birth setting.

This programme aims to improve safety for mothers and babies in low risk labour and birth by improving the knowledge, skills and confidence of midwives to undertake intermittent auscultation of the fetal heart in an intelligent manner (IIA). This will ensure early recognition of deterioration or abnormalities in the fetal heart rate and that situations requiring escalation and a move to continuous electronic fetal monitoring are recognised in a timely manner.

National reports (Each Baby Counts, RCOG, 2015 Full Report; Each Baby Counts RCOG 2018 Progress Report; Saving Babies Lives V2, NHSE 2019) highlight the importance of intermittent auscultation and specifically identify which aspects should be included in training and how this training should be assessed. This programme is timed to respond to these reports and is unique because it uses real fetal heart sounds to ensure that learning is interactive. It is the only training package available that can accurately assess competency of this skill. This is significant because prior to the development of this work it has only been possible to teach the theory of intermittent auscultation and assess knowledge meaning that the question of competency has remained unanswered.

More information

Who it is aimed at:

The programme is aimed at midwives and student midwives who care for low risk women in labour.

How learners will benefit from the course:

Learners will benefit through improved midwifery knowledge and skills to undertake IIA of the fetal heart safely and effectively improving safety for low risk labouring women. Through increasing their confidence in this midwifery skill, it will enable early recognition of deterioration of the fetus in labour; prompting appropriate escalation and move to electronic fetal monitoring.

Individuals and maternity services will have access to up to date staff training records and intermittent auscultation competency assessments.

Course content  

It is expected that midwives will have basic knowledge of fetal physiology related to the assessment of fetal wellbeing during labour, an understanding of changes in the fetal physiology in response to stress in labour and identify signs that the fetus is not coping normally.

Course content will focus on:

  • risk assessment of maternal and fetal wellbeing
  • enhanced skills in auscultation and interpretation of the fetal heart in low risk labouring women
  • prompt recognition of abnormalities in the fetal heart pattern
  • the ability to respond and escalate appropriately.

On completion of this interactive education and training package midwives will be able to:

  • describe the risk assessment that is required to accurately assess maternal and fetal wellbeing at the beginning of labour
  • describe how to undertake a thorough assessment of fetal wellbeing during labour using intermittent auscultation
  • discuss the ongoing risk assessment in labour
  • discuss when intermittent auscultation is appropriate or not
  • identify the situations which would prompt a move to continuous electronic fetal monitoring
  • listen to fetal heart sounds and identify the baseline rate and presence of abnormal features
  • evaluate their competency and learning by undertaking the pre and post training assessments.


60 minutes


Pre and post course training knowledge assessments

  • Christine Harding

    Christine Harding

    Consultant Midwife, Royal Berkshire NHS Foundation Trust
  • Wendy Randall

    Wendy Randall

    Consultant Midwife, Oxford University Hospitals NHS Foundation Trust
  • Eileen Dudley

    Eileen Dudley

    Patient Safety Manager and Maternity Network Manager, Oxford Academic Health Science Network
  • Emma Nye

    Emma Nye

    Project Manager, HEE elearning for healthcare
  • Simon Blackmore

    Simon Blackmore

    Learning Designer, HEE elearning for healthcare

How to access

In order to access the Intelligent Intermittent Auscultation programme, you will need an elfh account. If you do not have one, then you can register by selecting the Register button below.

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To view the Intelligent Intermittent Auscultation programme, select the View button below. If you already have an account with elfh, you will also be able to login and enrol on the programme from the View button.

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Not an NHS organisation?

If you are not an NHS health or care organisation and therefore do not qualify for free access elfh Hub, you may be able to access the service by creating an OpenAthens account.

To check whether or not you qualify for free access via OpenAthens, you can view the eligibility criteria and register on the ‘OpenAthens’ portal.

Registering large numbers of users

If you are a HR, IT or Practice Manager and would like to register and enrol large numbers of staff within your organisation for access onto the Intelligent Intermittent Auscultation programme, please contact elfh directly.

Organisations wishing to use their own LMS

For HR departments wanting to know more about gaining access to courses using an existing Learning Management System please contact elfh directly to express interest.

More information

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