Monitoring Labor
The invention of the fetoscope (a specialized stethoscope) changed birth. It allowed the midwife to listen to the baby's heart beat before it was born, alerting her to potential problems. As technology advanced, so did listening to the baby's heart. Today specialized ultrasound machines called electronic fetal monitors are able to print a continuous record of your baby's heart rate and your contraction pattern
There was an expectation that the ability to more closely track a baby's heart rate would improve outcomes for babies. If a midwife were able to see a problem earlier, she should be able to intervene before damage is done. Unfortunately, electronic fetal monitoring has not lived up to its expectations.
In the United States, almost every woman has electronic fetal monitoring at some point in labor. 90% of the respondents on the Listening to Mothers II Survey had continuous monitoring which means they were attached to the electronic fetal monitor throughout the entire labor. Despite the ability to keep such detailed records, the electronic fetal monitor has not reduced the death rate for babies, decreased the risk of a baby needing a special care nursery or improved the health of babies.
Being attached to wires connected to a small box is uncomfortable in several ways. First, some mothers find the belts used to attach the monitor itchy or uncomfortable. Secondly, the wires limit mobility, reducing the available space to about four feet around the box. Finally, the monitors can be fussy, requiring mothers to shift positions to help the monitor get a better reading rather than for comfort.
To add injury to the insult, continuous fetal monitoring with an electronic fetal monitor increases your chances of having a cesarean surgery or other operative delivery. Electronic fetal monitors also decrease the quality of your care by reducing the amount of time a caregiver is with you. When caregivers are with you, their attention may be focused on the monitor instead of you.
The good news is you may have options in how your labor is monitored. You may be able to have intermittent monitoring, meaning every 15 minutes or 15 minutes out of every hour. Talk to your midwife about how she prefers to monitor labor. You may also want to ask about your Options for Monitoring on a tour of the hospital.
References:
Goer, Henci. The Thinking Woman's Guide to a Better Birth. 1999. New York: The Berkley Publishing Group.
Enkin, Keirse, Nilson, Crowther, Duley, Hodnett and Hofmeyr. A guide to effective care in pregnancy and childbirth Third Edition. 2000. Oxford: Oxford University Press.
What would you like next?Understand what changes are being assessed during a cervical exam. Find local resources in the The Natural Childbirth Directory. Learn about comfort measures to help you manage labor. Discover ways to stay comfortable during pregnancy. Explore how exercise and nutrition can help you achieve your birth plan goals. |
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