Conclusions There is limited scientific evidence showing that the method can lead to a lower percentage of children with encephalopathy (brain dysfunction) and a reduced rate of operative vaginal deliveries (limited scientific evidence). Further scientific studies are needed to clarify the effects and the cost effectiveness of the method. The manual for interpretation and intervention reveals certain deficiencies that might lead to management that is too noninterventional. Continued utilization and diffusion of the method requires extensive education and training and also systematic follow-up of long-term effects.