If you’re planning to give birth in a hospital, no doubt you’ve heard about fetal monitoring. Most hospitals require some form of fetal monitoring during labor, although each facility varies on it’s specific policy.  Let’s discuss the basics of fetal monitoring during labor.

Estimated reading time: 5 minutes

What is the purpose of fetal monitoring during labor?

Fetal monitoring allows your healthcare team to observe your baby’s heart rate during labor.  Your provider will watch for signs that the baby is coping well or signs that baby might be stressed.  If there are abnormal changes in the heart rate, the goal is to then treat the underlying problem.

What are the different types of fetal monitors?

Fetal monitors fall under two main categories — external and internal fetal monitors.  Most of you are going to experience the use of external fetal monitoring during labor, so we’ll discuss these in more detail today.  Would you like to learn about more about the specific types of fetal monitors, both external and internal?  If so, read our post about the Pros and Cons of Fetal Monitors in Labor.

What types of fetal monitoring should I expect during labor?

For healthy women with low-risk pregnancies, external fetal monitors are most common.  External fetal monitors include auscultation, the ultrasound device, and the tocodynamometer.

• AUSCULTATION is when the provider listens to the baby’s heart beat with a fetoscope (a special type of stethoscope) or a handheld Doppler unit.  Intermittent auscultation is considered to be the safest type of fetal monitoring for mom and baby (ACOG, 2009).   This is when the provider periodically listens to the baby’s heart rate during labor.
• The ULTRASOUND DEVICE is an electronic fetal monitor that tracks baby’s heart rate.  It is placed low on the belly, near the area where the baby’s heart is.  It is normally worn together with the tocodynamometer.  Both monitors are held in place with flexible elastic belts that wrap around the belly.
• The TOCODYNAMOMETER is another electronic fetal monitor that measures how long and how often labor contractions are coming.  Please note that it doesn’t measure the intensity of the contractions. This means that partners shouldn’t watch the monitor to see if mom is having a “strong” contraction or not!  The tocodynamomether is placed high on the belly

How often can I expect to have fetal monitoring during labor?

This is a great question to sit down at your next prenatal visit and discuss with your doctor or midwife!  For a healthy mom and baby, expect intermittent fetal monitoring.  This is when the baby’s heat rate is monitored for a period of time, and then the monitors are removed.  Many hospitals require 15 minutes on the monitors, followed by 45 minutes off of the monitors.

Some providers and hospitals may use continuous fetal monitoring, even for a low-risk birth.  This means that moms are monitored from they moment they enter the hospital until the baby is born.  However, continuous fetal monitoring has been connected with higher cesarean rates in healthy women (Dekker, 2012).  It also limits mom’s mobility during labor.  Talk to your provider about their policy toward fetal monitoring during labor.

Can I move around when I’m wearing fetal monitors?

Yes, you can still use a variety of positions while you’re wearing fetal monitors.  However, your mobility will be somewhat restricted.  Electronic external fetal monitors are attached to cords that are then attached to a computer unit near the bed.  Moms can move, but only within the radius of the computer.  Tools like birth balls and rocking chairs are great options to increase mobility when you can’t walk around.  Some facilities offer telemetry, which is beltless, wireless electronic fetal monitoring.  Consider asking your provider if telemetry is available at your birth facility.

Another challenge of electronic fetal monitors is that they may loose the reading of baby’s heart rate if the belt shifts around.  At times you may be asked to sit in the bed for a brief period while the nurse obtains a good “strip,” or a clear reading of baby’s heart rate.

Fetal monitoring during labor is a common experience.  Do your research!  Talk to your provider during your upcoming prenatal visits to learn what you can expect, and advocate for the safest and most comfortable type of fetal monitoring for you and your baby.

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References:

1. American College of Obstetricians and Gynecologists (2009).  ACOG Practice Bulletin No. 106:  Intrapaartum fetal heart rate monitoring:  nomenclature, interpretation, and general management principles.  Obstet Gynecol, 114(1): 192-202.  doi:  10.1097/AOG.0b013e3181aef106
2. Chen, H.Y., Chauhan, S.P., Ananth, C.V., Vintzileos, A.M., Abuhamad, A.Z.  (2011).  Electronic fetal heart rate monitoring and its relationship to neonatal and infant mortality in the United States.  Am J Obstet Gynecol, 204(6): 491.e1-10
3. Dekker, R. (2012, July 17).  Evidene-Based Fetal Monitoring.  Retrieved from http://evidencebasedbirth.com/evidence-based-fetal-monitoring/
4. Fetal Heart Rate Monitoring During labor.  (2011, August).  Retrieved from http://www.acog.org/
5. Herbst, A., Ingemarsson, I. (1994).  Intermittent versus continuous electronic monitoring in labour:  a randomized study.  Br J Obstet Gynaecol., 101(8):663-8.
6. Olds, S.B., London, M.L., & Ladewig, P.W. (2000).  Maternal-newborn nursing:  A family and community-based approach.  Upper Saddle River, NJ:  Prentice Hall Health, 160-161.

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