Is Baby OK During Labour?

Monitoring

How do you know your baby is OK during your labour? There are 5 types of monitoring.


The 5 types of monitoring are: Pinard stethoscope, hand held Doppler, Electronic Foetal Monitor (EFM), foetal scalp electrode and foetal blood sampling.

Pinard

(stethoscope or ear trumpet)

• This enables a midwife to hear the baby's heart.
• The woman can adopt any position she likes.
• No electronics at all.


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ultrasound monitor

Doppler

(hand held ultrasound)

• This allows the woman to adopt whatever position she likes during labour.
• The advantage of the Doppler is that you can hear the heartbeat too.


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Electronic foetal monitoring (EFM) or Belt Monitor

Two receivers are held in place by belts around the woman's waist and hips. One monitors contractions and the other, the baby’s heartbeat. This is done for 20- 30 minutes, and in certain cases continues throughout labour.

Advantages of EFM
• Reassures midwife/couple that all is well
• Printout available

Disadvantages of EFM
• Women may be left alone more by midwife while monitoring is on
• Everyone tends to focus more on the trace than on the woman as it is distracting
• Open to differing interpretations by different staff
• Can't use water during labour
• Not so easy to adopt positions you want in labour, midwives prefer you to be on the bed during monitoring. But can be done while sitting on chair.
• More likely to have a Caesarean section

On arrival at hospital you may be offered a 20 minute monitor, this used to be standard practice but is not now, in all hospitals. Now it is usually suggested only if there is some risk, you have a medical condition, or you are expecting some intervention such as induction. In a low risk labour no advantage has been shown in doing this. If you are offered it and do not want it, please say so, or ask for an explanation.

Research has shown that in a 'low risk' labour there is no need for continuous monitoring, this is only advised where some intervention is used, such as a drip to encourage labour. (Examples of 'high risk' labours: baby seems smaller than expected, mother has high blood pressure, twins, the previous baby was Caesarean section, the labour has lasted a long time.)


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Fetal Scalp Electrode

An electrode is fastened by means of a small wire onto the baby's head, or other lowest (presenting) part, via the vagina. The electrode is on a thin wire and once in place is not removed until the baby is born. It measures the foetal heart rate more accurately than the EFM belt. TENS may interfere with it so cannot be used together, and also it cannot be used in water. You won’t find it very easy to move around.
If your waters have not broken naturally, you will need artificial rupture of the membranes (ARM) before this test can be carried out, as the amniotic membrane will be in front of the baby.


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Foetal Blood Sampling

The most accurate form of monitoring, this measures whether you baby is receiving enough oxygen. It is not open to differing interpretations, as the belt monitor may be. A small blood sample is taken from the nearest part of your baby. If the baby is low in oxygen, its blood pH (acidity) will become higher.

Several tests will show whether the result is a one-off ,or a trend. There is, however, a limit to how many will be performed during labour. Blood sampling is usually performed as a second test, if the electronic foetal heart rate monitor shows the heart rate to be abnormal.

If your waters have not broken naturally, you will need artificial rupture of the membranes (ARM) before this test can be carried out, as the amniotic membrane will be in front of the baby.


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Also see


Is Baby OK? Encouraging baby into a good position for labour
Optimal Foetal Positioning may contribute to an easier labour

Pregnancy and Childbirth: Natural and Homeopathic Remedies
Tips for getting labour started, and more

Breastfeeding: Natural and Homeopathic Remedies
Tips to encourage breast milk, and more

BACK TO Pregnancy and Childbirth Intro page and full list



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