What is fetal monitoring?
Fetal monitoring is defined as watching the baby's heart rate for indicators of stress, usually during labor and birth.
Define the types of fetal monitoring
Fetoscope: This is a special type of stethoscope used for listening to a baby. There are many types of fetoscopes available, and a regular stethoscope works as well. This can usually be used after about 18 weeks.
Doppler: This is a handheld ultrasound device that transmits the sounds of the baby's heart rate either through a speaker or into ear pieces that are attached. This can generally pick up heart tones after 12 weeks gestation.
Electronic Fetal Monitoring: This is an ultrasound device used during labor and birth, or during certain testing (non-stress test, contraction stress test, etc.) to record the baby's heart rate, and sometimes mother's contractions. It can be used intermittently or continuously.
Internal Fetal Monitoring: It is an internal monitoring with an electrode attached to the baby's head to record heart tones, and a pressure catheter to record contractions. This is also used during labor and birth, however, it is not used intermittently.
Telemetry Monitoring: It is a lot like the regular Electronic Fetal Monitoring, however, one can maintain mobility.
What are the benefits and risks?
Fetoscope: This method is non-invasive, simple to use, and has a live person on the other end (This can prevent some of the errors that are mechanical.). This gives mother the mobility to deal with her labor, shower, etc.. It does require that the person using it be trained, although it is a standard procedure taught in every medical and nursing type institution. In the case of high risk, induced, or with certain medications, it cannot provide the round the clock monitoring that may be necessary.
Doppler: This method is also used intermittently, requires little training to use, has a live person on the other end, and allows mother to maintain her mobility. It may also be easier to use during a contraction. This device does use ultrasound and does not provide the continuous monitoring needed for high risk labors.
Electronic Fetal Monitoring: This method provides beat to beat view of the baby's heart tones, in relationship to mother's contractions. This may be used either continuously or intermittently. This is a benefit for the high risk mother, but of questionable benefit to the low risk mother. This method does use ultrasound; leaves room for mechanical error, which may cause incorrect interpretation, unnecessary interventions etc.; loss of maternal mobility (when in use), which may slow labor; and may switch attention from the mother to the machine.
Internal Monitoring: This is more accurate than the electronic monitoring, does not use ultrasound, and can provide continuous monitoring for the high risk mother. This method requires that your water be broken (An amniotomy will be performed if you water is still intact.), and that you be 2-3 centimeters dilated. Amniotomy adds risks of its own. However, the risks and benefits of each procedure must be weighed. This type of monitoring is almost exclusively used in high-risk situations or when more accurate types of monitoring may prevent other unnecessary interventions. This type of monitoring also has been associated with fetal injury (from the electrode), infection for mother or baby, etc.
Telemetry Monitoring: This is the "newest" type of monitoring available. It uses radio waves, connected to a transmitter on your thigh, to transmit the baby's heart tones to the nurses station. You maintain your mobility, and have constant monitoring, but again, continuous monitoring for the low risk mother is very questionable in benefit.
Which is right for me?
We have talked about the different type of monitoring available. There is no one right way for every woman. Depending on your choices of labor management, your monitoring will be tailored (If you talk to your care provider before hand, many have standards that you wish to avoid.) to your situation. If you are high risk, are induced, or choose epidural anesthesia you will be more likely to have continuous monitoring
Think about your labor choices and how you plan to cope with labor. Study the different types of monitoring and talk to your care provider. Be aware of what is going on with the standards of monitoring in your community.
Problems with Standard Practices of Fetal Monitoring
The problems with standard fetal monitoring is that we tend to want to use continuos fetal monitoring on everyone. However, today we know that in most cases, routine continuous fetal monitoring of every woman does not improve fetal or maternal outcomes, it only tends to increase the cesarean rates. We have found that using a fetoscope or doppler is just as effective in predicting fetal well-being.
From Childbirth.org
Fetal monitoring is defined as watching the baby's heart rate for indicators of stress, usually during labor and birth.
Define the types of fetal monitoring
Fetoscope: This is a special type of stethoscope used for listening to a baby. There are many types of fetoscopes available, and a regular stethoscope works as well. This can usually be used after about 18 weeks.
Doppler: This is a handheld ultrasound device that transmits the sounds of the baby's heart rate either through a speaker or into ear pieces that are attached. This can generally pick up heart tones after 12 weeks gestation.
Electronic Fetal Monitoring: This is an ultrasound device used during labor and birth, or during certain testing (non-stress test, contraction stress test, etc.) to record the baby's heart rate, and sometimes mother's contractions. It can be used intermittently or continuously.
Internal Fetal Monitoring: It is an internal monitoring with an electrode attached to the baby's head to record heart tones, and a pressure catheter to record contractions. This is also used during labor and birth, however, it is not used intermittently.
Telemetry Monitoring: It is a lot like the regular Electronic Fetal Monitoring, however, one can maintain mobility.
What are the benefits and risks?
Fetoscope: This method is non-invasive, simple to use, and has a live person on the other end (This can prevent some of the errors that are mechanical.). This gives mother the mobility to deal with her labor, shower, etc.. It does require that the person using it be trained, although it is a standard procedure taught in every medical and nursing type institution. In the case of high risk, induced, or with certain medications, it cannot provide the round the clock monitoring that may be necessary.
Doppler: This method is also used intermittently, requires little training to use, has a live person on the other end, and allows mother to maintain her mobility. It may also be easier to use during a contraction. This device does use ultrasound and does not provide the continuous monitoring needed for high risk labors.
Electronic Fetal Monitoring: This method provides beat to beat view of the baby's heart tones, in relationship to mother's contractions. This may be used either continuously or intermittently. This is a benefit for the high risk mother, but of questionable benefit to the low risk mother. This method does use ultrasound; leaves room for mechanical error, which may cause incorrect interpretation, unnecessary interventions etc.; loss of maternal mobility (when in use), which may slow labor; and may switch attention from the mother to the machine.
Internal Monitoring: This is more accurate than the electronic monitoring, does not use ultrasound, and can provide continuous monitoring for the high risk mother. This method requires that your water be broken (An amniotomy will be performed if you water is still intact.), and that you be 2-3 centimeters dilated. Amniotomy adds risks of its own. However, the risks and benefits of each procedure must be weighed. This type of monitoring is almost exclusively used in high-risk situations or when more accurate types of monitoring may prevent other unnecessary interventions. This type of monitoring also has been associated with fetal injury (from the electrode), infection for mother or baby, etc.
Telemetry Monitoring: This is the "newest" type of monitoring available. It uses radio waves, connected to a transmitter on your thigh, to transmit the baby's heart tones to the nurses station. You maintain your mobility, and have constant monitoring, but again, continuous monitoring for the low risk mother is very questionable in benefit.
Which is right for me?
We have talked about the different type of monitoring available. There is no one right way for every woman. Depending on your choices of labor management, your monitoring will be tailored (If you talk to your care provider before hand, many have standards that you wish to avoid.) to your situation. If you are high risk, are induced, or choose epidural anesthesia you will be more likely to have continuous monitoring
Think about your labor choices and how you plan to cope with labor. Study the different types of monitoring and talk to your care provider. Be aware of what is going on with the standards of monitoring in your community.
Problems with Standard Practices of Fetal Monitoring
The problems with standard fetal monitoring is that we tend to want to use continuos fetal monitoring on everyone. However, today we know that in most cases, routine continuous fetal monitoring of every woman does not improve fetal or maternal outcomes, it only tends to increase the cesarean rates. We have found that using a fetoscope or doppler is just as effective in predicting fetal well-being.
From Childbirth.org
