Dr Sholapurkar’s comments perhaps reflect a difference in experience. We do not find this algorithm to be particularly complicated, or beyond the ken of practicing clinicians with whom we work, most of whom also have no difficulty distinguishing late from variable decelerations. Certainly the ability to apply a simple 2 or 3 step decision tree to a category II FHRT, and to correctly identify basic FHR patterns is requisite to use of this algorithm. Given the absence of data suggesting improved outcomes with fetal scalp blood sampling, this technique, abandoned decades ago in the US, is not likely to be revived. However, current practice involving interpretation and intervention based on widely disparate individual experience and “judgment” has been little short of disastrous and without a testable baseline hypothesis is likely to continue. Further, having cumulatively authored well over 300 publications dealing with these specific issues, we somehow find an academic discussion of the acknowledged theoretical imperfections of the NICHD classification or of this algorithm of little benefit unless the author has something more concrete or better to offer.