Doula Chats: Fetal Monitoring

What is fetal monitoring? What valuable information do we gain from fetal monitoring, and what are the risks and benefits? What are my options with fetal monitoring?

Fetal monitoring is when providers use tools to measure the baby’s heart rate and/or the intensity of your contractions. How often this monitoring is done and how it is measured depends on your preferences, the policies of your birthing location, and the preferences of your provider.

Hospitals/OBGYN

In hospitals, typical fetal monitoring looks like a wide elastic band with button holes attached to a round disc and a wire leading to a Cardiotocography machine - “CTG” for short. This machine measures your baby’s heart rate as well as the intensity of your contractions.

Standard policy for most hospitals is to place this machine on your belly continuously throughout your labor - especially if you have chosen to have an epidural - or every so often for at least a half an hour at a time.

Birthing Centers/Midwives

Birthing centers typically do not have CTG machines and the midwives tend to be more hands-off with fetal monitoring. They will usually perform monitoring using a handheld doppler and depend on you to tell them the intensity of your contractions. How often they do it may depend a little on your situation, and also largely on your own personal preferences.

What are my options?

Whether you’re birthing at the hospital, in a birthing center, or at home, you have options.

• None
• Handheld Doppler
• Intermittent
• Continuous (with an option of wireless)
• Internal

Which option is right for me?

The answer to this question is the same answer to many other questions about your birth… It depends on what kind of birth experience you want. Here are some important notes to consider:

• Continuous monitoring means you will be confined to your bed so that the monitor will stay in place UNLESS your hospital provides you the option for a wireless monitor.
• Monitoring often provides too little information and should not be depended on to make all decisions and has not be proven to decrease the rate of stillbirths and perinatal deaths.
• Fetal Monitoring is an intervention and can lead to additional interventions in order to prevent possible negative outcomes.
• Internal fetal monitoring can not be accomplished unless the amniotic sac is already broken.
• Studies have shown that the rate of cesarean deliveries rises with the use of internal fetal monitors.

My Opinion:

I am always supportive of mothers who go with their gut. It is important to me that my clients have been informed of what their options for their birth are so that they can make the decisions that feel right. If the mother is interested in having a low-to-no intervention birth, she should choose to either have no monitoring or monitoring with a handheld doppler. In my experience, the continuous monitoring via the elastic belt and CTG machine, is a hassle. Oftentimes, the nurses have a hard time placing the monitor in the right position to pick up the baby’s heartbeat, and once they do, they don’t want you to move, otherwise they’ll lose the heartbeat and have to replace it. This can complicated labor because movement is so important in labor.

If you’re at a birthing center or having a home birth, continuous monitoring will not even be an option, so your choice is more in regards to whether to have monitoring at all. I would choose to have it intermittently.

Thanks for stopping by and learning more about your birth options today! Always remember that you have options and to go with what feels right to you. Good luck, Mamas!

References:

Cochrane Review

ACOG

Evidence Based Birth

*Susan Joy is a Doula and Birth Documenter serving the families of Mesa, Gilbert, Chandler, Scottsdale, Queen Creek, San Tan, and other cities in the East Valley. The information presented here is not medical advice. All medical decisions should be made after discussion with your medical provider.*