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To the Editor.—
The conclusion of the report by the Council on Scientific Affairs contains a striking illustration of a problem that should be faced if the American Medical Association is to continue to be considered the prime representative of the medical community. In conclusion the report states that continuous electronic fetal monitoring (EFM) is clearly warranted in high-risk pregnancies. It also states that "It is clear that many intrapartum events may occur that might change a low-risk pregnancy to a high-risk one. Therefore, the use of EFM in low-risk pregnancies should not be denied the patient or her physician who might choose that option."The problem is, who should pay for continuous EFM in low-risk pregnancies? If the community accepts responsibility for these costs through government programs or third-party payments, failure to use EFM might well seem foolish to the patient and the physician, particularly since because of the
Shapiro MJ. Electronic Fetal Monitoring. JAMA. 1982;247(18):2500. doi:10.1001/jama.1982.03320430023020