| Sumario: | Background/Aims: Fetal growth assessment in midwifery-led care relies on symphysis–fundal height measurements, with deviations prompting ultrasound referral. Repeated scans, despite normal findings, can increase interventions and maternal anxiety. This project aimed to highlight if fewer growth scans could maintain safety, reduce unnecessary interventions and improve service efficiency. Methods: This mixed-methods study involved a 6-month retrospective audit of 204 growth charts of women referred for at least two growth scans at an NHS trust in southwest England, as well as patient and public involvement discussions with five women who had experienced the service. Quantitative audit data were analysed using descriptive statistics, while qualitative data from the discussions were analysed thematically. Results: Audit data showed that 45% of women had babies estimated to be in <10th centile by symphysis–fundal height, yet 85% of scans were normal and only 9% of babies were in <10th centile at birth. Almost half of women received conflicting referrals. Women reported that the process was confusing and stressful, supporting the need for improvement. Conclusions: Discrepancies between plotting methods led to additional scans. Clearer referral pathways and enhanced symphysis-fundal height training could reduce unnecessary scans and associated anxiety. Implications for practice: Changes to current protocol are needed to ensure care consistency in appropriate referrals. Training opportunities for midwives through mandatory study days and e-learning modules should promote continuity. An outside organisation could be consulted to develop a face-to-face training package for midwives.
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