After nine months of peacefully floating in a warm and cozy uterus, babies can become stressed out by uterine contractions and the tight squeeze through Mom’s pelvis during childbirth.
Most babies sail through like little troopers. Some, however, may respond with decelerations or accelerations in heart rate, rapid or slowed-down movement, or other signs of fetal distress.
Electronic fetal monitoring gives your practitioner important insight into how your baby is handling labor and delivery. Here’s when it’s necessary and what to expect during your labor.
Types of fetal monitoring
There are two types of fetal monitoring:
- Intermittent auscultation: Periodically listening to baby’s heartbeat at set times throughout labor by pressing a special stethoscope or Doppler device against your belly. If you have problems during labor, your baby’s heart rate may be checked more frequently.
- Electronic fetal monitoring: Continuously monitoring your contractions and your baby’s heartbeat during labor.
The type of monitoring you’ll receive and when depends on your risk factors, the duration of your labor and the policy of your hospital or practitioner.
What is electronic fetal monitoring?
Electronic fetal monitoring is using special equipment to continuously gauge your baby’s heartbeat in response contractions. Doing so allows your practitioner to assess how your baby is handling labor.
Why is electronic fetal monitoring done?
Electronic fetal monitoring ensures your baby's health and safety during labor and delivery by:
- Reassuring you and your practitioner that it’s safe to continue with labor and delivery, as long as a normal heartbeat is detected and there are no other problems.
- Notifying your practitioner of changes in heart rate so he or she can take steps to address the underlying problem. You may, for example, be asked to change positions to help your baby get more oxygen.
- Informing your practitioner when it’s risky to continue with labor and immediate delivery is necessary. If abnormal readings continue, further tests can help determine the cause of the distress. If they suggest your baby has a problem, you’ll usually deliver by C-section or with forceps or vacuum-assisted delivery.
When is electronic fetal monitoring done?
Most experts say that electronic fetal monitoring isn’t necessary in many cases.
Read This Next
The latest research shows that for low-risk moms with unmedicated deliveries, auscultation (or intermittent fetal heart checks) are an effective way to periodically assess fetal condition.
You may, however, be hooked up to an electronic fetal monitor throughout labor without any breaks if you:
- Are being induced
- Have opted for an epidural
- Have other risk factors (such as meconium staining)
Types of electronic fetal monitoring
If your practitioner opts for electronic fetal monitoring, there are three types he or she may use:
External monitoring
This kind of monitoring is used most frequently. An ultrasound transducer is strapped over your abdomen to pick up the baby's heartbeat. A second, pressure-sensitive gauge is strapped to the top of your abdomen to record the frequency and power of your contractions.
Both detectors are connected to a monitor, and the measurements are recorded on a paper readout. These two measurements give your practitioner detailed information about how your baby is handling labor.
When you’re connected to an external monitor, you’ll be able to move around on your bed or in a chair nearby. You won’t, however, be able to move about freely unless telemetry monitoring is being used.
During the pushing stage of labor, the monitor can accurately signal the beginning and end of each contraction. It may also be removed entirely during this stage, so it doesn’t interfere with your concentration. Instead, you’ll be monitored periodically with a Doppler.
Internal monitoring
Internal monitoring gives a slightly more accurate record of the baby's heart rate and your contractions than an external monitor. It’s sometimes used when there’s reason to expect fetal distress — although because there is a small risk of infection, it's only used when necessary. It can only be used after your water has broken.
A tiny electrode is inserted through your vagina onto your baby's scalp. A catheter is also placed in your uterus, or an external pressure gauge is strapped to your abdomen, to measure the strength of your contractions.
You’ll be more limited in your movement than with an external monitor, but you’ll still be able to move from side to side. Your baby may have a small bruise or scratch where the electrode was attached, which will disappear on its own within a couple of days.
Telemetry monitoring
This type of fetal check uses a transmitter on your thigh to transmit the baby's heart tones to the nurse's station via radio waves. The equipment, however, is not available in all hospitals.
The big upside to this technology is it allows you to maintain your mobility while still having constant monitoring.
When is it not advised to do electronic fetal monitoring?
The latest guidelines from the American College of Obstetricians and Gynecologists (ACOG) recommend intermittent fetal monitoring using a Doppler or special stethoscope for low-risk pregnancies where Mom and baby aren't in need of constant tracking.
If you fit into that category and you and baby are progressing normally, you probably won't be attached to an electronic fetal monitor for the entire duration of your labor.
Are there any downsides or risks of fetal monitoring to the baby and me?
- Electronic fetal monitoring can limit your ability to get up and move about freely to cope with contractions during labor and delivery.
- Some research has suggested that continuous electronic fetal monitoring may increase the risk of C-section and other labor interventions compared with intermittent monitoring.
- False alarms are common with electronic fetal monitoring. The machine can start beeping loudly if the transducer slips out of place, the baby shifts positions or contractions suddenly pick up in intensity. Your practitioner will take this into account before proceeding with other tests or procedures.
Wondering whether electronic fetal monitoring will be necessary for you — or hoping to avoid it altogether? Talk to your practitioner about your options.
While continuous monitoring is no longer necessarily par for the course in the delivery room, in some circumstances it’s essential to help your doctor to make the best decisions for the health and safety of your baby.
Yes 
No 
Trending On What to Expect
