How to Understand Fetal Monitoring
Fetal monitoring is watching and listening to the baby’s heart rate for indicators of stress, particularly during labor and birth.
There are essentially four different types of monitoring available-therefore it is good to know the difference between them and the risks and benefits of each type so that you can make informed decisions throughout your labor.
4 Steps to Understand Fetal Monitoring
1. A fetoscope is a special type of stethoscope made for listening to fetal heart tones.
Unlike a doppler, it is non-invasive and the person listening through the fetoscope must be trained to correctly position the instrument and hear the heart tones. A fetoscope is commonly used with midwives who do home deliveries. Heart beats can be heard with a fetoscope typically after 20 weeks.
2. A doppler is the most common instrument used during pregnancy.
It is a handheld ultrasound device that transmits the sound of the baby’s heart rate through a speaker. A doppler is used intermittently and allows the mother to maintain her mobility while in use. Dopplers can still hear the heartbeat through the tightening of a contraction.
3. Electronic fetal monitoring is done during labor and birth or with certain tests such as a non-stress test or a contraction test.
There are two flat dopplers that are secured to your belly through flexible belts. One monitors the baby’s heartbeat and the other monitors the contractions. This type of monitoring can be used intermittently or continuously.
Using it continuously will limit maternal mobility, so if the fetal heart tones are doing well, it’s best to ask for intermittent monitoring. This is generally done by putting the monitors on for 15 minutes out of every hour.
4. Internal fetal monitoring is by way of an internal monitor that has an electrode screwed into the baby’s head to record the heart beat.
They will also insert what is called an IUPC, a pressure catheter that is used to record contractions. These are used during labor and birth and are used continuously until birth. This type of monitoring is more accurate than electronic fetal monitoring and may be used if they cannot get consistent heart tones any other way.
In order to use this type of monitoring, the amniotic sac must be ruptured and some dilation is necessary. The risk of fetal injury (from the electrode) and an infection for both mother and baby are present.
Tips and Warnings
- Know the risks and benefits of each type of monitoring before you agree to it.
- If heart tones are sounding fine, ask for intermittent monitoring. This will allow you to have more motility than continuous monitoring.
- Certain types of monitoring may require staying in bed. Get clarity on this before being hooked up.