What Are My Options for Fetal Monitoring
Most care providers will want to keep an eye on your baby while you are in labor. There are several options available for fetal monitoring. Some fetal monitoring needs to be continous and some fetal monitoring can be intermittent. Read on to find out your options!
Continuous Fetal Monitoring
If you are considered a high-risk pregnancy, if you are being induced or your labor is being augmented with medication like Pitocin, if your provider has concerns about your baby after doing some intermittent monitoring, or if you are using pain medication, your provider will likely recommend continuous fetal monitoring until your baby is born.
You have a few options with continuous fetal monitoring. The traditional monitoring is done externally. This means having TOCO monitors attached to your abdomen with a fabric belt. Traditionally, this monitor would then be connected to the computer near your bed. These TOCO monitors not only measure your baby’s heart rate, but they also measure how frequently you are having contractions. Typically you have about a 6 ft length of cord so you are still able to stand by your bed, sit on a labor ball, or even sway back and forth. You would need to disconnect from this kind of monitor if you wanted to go to the bathroom or get in the shower. If you need to stay in bed due to blood pressure medications, or, if you have an epidural, this is most likely the kind of monitoring that will be used.
Another option for continuous fetal monitoring is to use the wireless monitors. Most hospitals now have at least one set of wireless monitors available for use. Ask your care provider if this is available at your hospital. The TOCO monitors are still attached with the fabric belts but you are not hooked up to any cords. This makes freedom of movement much easier. In many cases, you can even get in the bath or shower during your labor but check first with your nurse to make sure that your monitors are waterproof.
Some hospitals even have an alternative option for wireless and continuous monitoring, called the Monica Novii. The Novii uses sticky pads placed on your abdomen and bluetooth technology to monitor your baby’s heartrate. The Novii eliminates the use of fabric belts and minimizes the need to constantly reposition TOCO monitors. This monitor is also waterproof. The Monica can also be a great fit for folks who have fuller figures.
If your care provider is concerned about your baby’s heart rate and they aren’t able to get an accurate reading over time, they may recommend switching to an internal monitor. To better monitor fetal heart rate, they would ask to place a fetal scalp electrode. This electrode is placed on your baby’s head, just under their skin. This electrode allows direct fetal monitoring. Your provider would need to break your water in order to place this monitor.
Intermittent Fetal Monitoring
Intermittent fetal monitoring may be an option for you if you have a low-risk pregnancy, aren’t being induced with medications, your baby has reassuring heart tones, and if you aren’t using pain medication.
Just like above, you can use the monitors that plug into the computer or use the wireless monitors. Typically, your nurse will want to monitor your baby’s heart rate at least once an hour for about 10 minutes. In some cases, you may even ask your nurse to do “spot checks” with the wireless monitor. This is where your nurse can hold the wireless monitor to your abdomen and listen to your baby for a few contractions. This can be a great option if you are “in the zone” and don’t want to stop what you are doing to get hooked up to anything. Your nurse will likely increase frequency of monitoring when you start pushing.
One other option you have for intermittent monitoring is to request the use of a Doppler. We find that many midwives prefer to use the Doppler. The Doppler is compact and easy to transport to wherever you might be laboring. The nurse or midwife would hold the Doppler to your abdomen and listen to your baby’s heart rate through a few contractions. The Doppler would be used each hour for a few minutes at a time and more frequently during the pushing stage.
Talk your provider to see what kind of fetal monitoring they recommend for your labor and birth. It is always OK to ask your provider to review benefits, risks, and alternatives for anything they might recommend.