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Electronic fetal monitoring

This high-tech replacement for the ear trumpet is used to track your baby's heartbeat. In all high-risk pregnancies, electronic fetal monitoring (EFM) or a cardiotocograph (CTG) will be used throughout labour for your own and especially your baby's safety.

Fetal monitoring
© Jupiter

You'll have monitoring if you are being induced or your labour is being accelerated for any reason, or if you're having epidural anaesthesia. The main function of the monitoring is to give early warning if your baby is in any distress.

What is fetal monitoring?

There are two kinds of electronic monitors, external and internal. A hand-held external monitor is used for routine short periods of monitoring. Sometimes it's necessary to monitor the baby's heartbeat over a longer period of time. For this a special belt with sensors that record the baby's heartbeat and your uterine contractions is strapped around your abdomen, the readings are then printed out on a graph.

The internal monitor is slightly more accurate. You'll have a belt strapped around your body and a tiny electrode will be clipped on to your baby's scalp once your cervix is 2-3cm (1-1 ¼ in) dilated. The baby's heartbeat is printed out on a paper trace.

How does electronic fetal monitoring work?

During a contraction, the blood flow to your placenta is reduced for a few seconds, and your baby's heart rate may dip. The heart rate should return to what it was before when the contraction passes. If it doesn't or the return is delayed, your baby may be distressed and your medical team may need to take action to protect his wellbeing.

If the medical staff are worried that your baby is not getting enough oxygen, they may want to take a tiny sample of his blood - a fetal blood sample (FBS). Analysis of this blood gives your doctor and midwife a good idea of how your baby is coping with labour.

How monitoring helps doctors?

EFM provides medical staff with a second-by-second report on your baby's condition. It alerts the doctors if your baby is in distress so that they can intervene before anything untoward has happened. If your doctors decide that you and your baby would be better off with monitoring, try not to resent it. Look on it as something that gives reassurance that your baby is doing fine.

Disadvantages

The use of monitoring means that there'll be more electronic equipment in the delivery room, making the atmosphere very clinical. You may also feel that the midwifery staff might concentrate more on the machine than on you. As they are aware of any tiny changes that may take place, they're more likely to intervene rather than letting labour take its natural course.

However, many mothers do find it comforting to know that the doctors and midwives will know right away if there are any problems with the baby during labour.

Posted 16.11.2010

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