Fetal Monitoring - Which Type is Right For You?
Like many people, you may not have realized that you have a choice between wearing a continuous electronic monitor and having your baby's heart rate checked manually and intermittently throughout your labor. But you do!
Continuous fetal monitoring is done through ultrasound sensors that are placed on the parent's stomach throughout labor, constantly receiving signals to record the baby's heart rate as well as the parent’s uterine contractions. Providers use the information gathered to assess how baby’s heart rate responds to contractions.
Intermittent monitoring is done with a fetal stethoscope or handheld Doppler, through which your provider or nurse listens to the baby's heart rate in intervals throughout labor, typically every 15-30 minutes or so (more frequently during transition and pushing).
A benefit of continuous monitoring? Depending on your preferences, you may find comfort in having your baby's heart rate constantly monitored. All birth preferences are valid. Though evidence does not necessarily support its use, some providers feel more comfortable using continuous electronic monitoring in high-risk labors, during induction, and with the use of epidural.
A benefit of intermittent monitoring? For one, you are not attached to a monitor and may have more mobility throughout labor. Additionally and perhaps more importantly, evidence has shown that intermittent monitoring is safe and is correlated with a lower instance of Cesarean birth and lower rate of use of surgical instruments to assist a vaginal delivery. Babies whose labors were monitored with intermittent monitoring were not shown to have any worse outcomes than those who were monitored continuously. Because of these benefits, the American College of Obstetricians and Gynecologists has recommended intermittent monitoring for low-risk birthers (with continuous monitoring recommended in certain high risk situations such as prior cesarean, preeclampsia, use of pitocin, etc.).
So you may ask, if the benefits of intermittent monitoring outweigh the risks of continuous fetal monitoring for the parent without increasing risks to the newborn, why are most people in a hospital setting continuously monitored (approx 89%!)? The answer is likely because continuous monitoring is more convenient for providers in hospital settings. Hospital staff may not be accustomed to using intermittent monitoring, and providers may be less comfortable with it because of a lack of use.
We encourage our students to talk to their providers about their preferences. In regards to monitoring, you can ask your provider how often they use intermittent monitoring and whether they would be comfortable using it for your labor. If mobility is a primary motivator for you in requesting intermittent monitoring and your provider does not offer intermittent monitoring, you can also inquire about wireless electronic monitoring, which is an option in some hospitals.
We encourage you to book a childbirth class with us or a private birth planning session to go over your options, rights, and intentions for your birth. We would love to support you and help you prepare for a positive, empowered birth experience!
