What is electronic fetal monitoring during labour?

Even though you may be working towards a natural birth when it comes to labour things don't always go according to plan. You'll want to be aware of your options when it comes to medical interventions so that you can make informed decisions.

If you are considered a high risk pregnancy due to a condition that puts you or your baby at a higher than normal risk for complications during or after the pregnancy and birth, you and your baby will need to be monitored.

Let's go through some of the interventions used.

Vaginal Examinations (VE)

An 'internal' or vaginal examination is a procedure to determine how dilated or open your cervix is. Usually you will be asked to lie on your back and the midwife or doctor will insert their hand into your vagina and feel where your cervix is sitting and how dilated it is.

This can be an uncomfortable procedure but you can choose whether you would like to have vaginal examinations or not. Some women prefer to have this procedure as they want to know how dilated they are. Other women can be discouraged if their cervix isn't as dilated as they thought it would be.

A good time to have an internal is if you're wanting medical pain relief or you've reached a crisis of confidence. Knowing where your body is at and knowing it can change very quickly can give you the confidence to carry on with your labour.

Fetal Monitoring

Fetal monitoring is where your baby's heart rate and your contractions are monitored during labor. There are a couple of different ways this can be done.

Intermittent Fetal Monitoring

The most common way of monitoring is intermittently with a midwife using a hand held Doppler over your stomach for routine checking every 20 minutes.

Continuous Fetal Monitoring

Continuous fetal monitoring is when two transducers are strapped onto your stomach and the wires are connected from the transducers to the monitor. During an induction, epidural or if there is concern for your baby, this type of monitoring is necessary.

There are some downsides to continuous fetal monitoring. With a normal labour the bands can limit your ability to move around and get into different positions during labour. The focus can tend to be on the monitor and not on the labouring mother and it can create false alarms if the transducers lose contact with your baby. This can sometimes lead to further interventions that may not have been necessary. Wireless or waterproof fetal monitors can be used, however it depends on their availability.

Continuous monitoring attached to baby's head

Continuous monitoring can be done internally by inserting a clip through your cervix and attaching it to your baby's skull. If your baby is not at high risk, this type of monitoring is invasive and unnecessary.

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