We all know that normal, traditional hospital policy is to put every woman on a doppler ultrasound machine and a pressure sensor during labor. The doppler ultrasound machine monitors the baby’s heart rate, while the pressure sensor monitors mommy’s contractions. Both of these devices record all the activity, gets printed out and links to hospital staff so they can watch it from another part of the hospital. This is done continuously during all of labor until birth is achieved. But what is the evidence for continuous fetal monitoring?🤔 Do you have another option?🤔
📌studies show that continuous fetal monitoring can lead to more interventions without actually improving the outcomes for mother and baby
📌continuous fetal monitoring leads to:
➖higher risk of cesarean delivery
➖restricting your ability to walk
➖higher risk of forcep/vacuum delivery
➖higher risk of needing pain medication
📌the whole point of continuous fetal monitoring is to monitor the baby’s heart rate during labor to identify oxygen problems in the baby that can lead to complications such as cerebral palsy, brain damage, newborn seizures, or death. unfortunately this method of monitoring is more risky intervention wise. False positives for predicting cerebral palsy are 98.7%!! In addition, just because you’re on the monitors the whole time, IT DOESNT MEAN STAFF IS WATCHING THE WHOLE TIME!
📌let’s look at intermittent fetal monitoring. here we ask care providers to monitor mommy and baby on the monitors for 20-30 minutes out of every hour. this reduces the amount of time on monitors significantly. but is it any better than continuous fetal monitoring? NO! studies show that the outcomes for mother and baby still didn’t change!
📌another reasonable option, which reduces your risk of intervention, is healthier for you and baby, and keeps you very mobile which helps get baby out, is to do INTERMITTENT AUSCULTATION. During intermittent auscultation, your care provider listens to the baby’s heart rate for about 60 seconds using a fetal stethoscope or a hand-held Doppler ultrasound device. While listening, the care provider also palpates the mother’s contractions by placing a hand on the abdomen. Intermittent auscultation should be done every 15-30 minutes during the active phase of the first stage of labor (from 5-10 cm dilation) and every 5-15 minutes during the pushing phase.
📌you have the right to refuse hospital “policy”. their “policy” of continuous fetal monitoring is mostly done out of tradition. But most of all, LIABILITY. with continuous fetal monitoring they have record in the event of a lawsuit. many hospitals don’t carry hand-held dopplers and many care providers don’t have experience with a fetal stethoscope or hand-held dopplers during labor 😱
❌CONTINUOUS FETAL MONITORING IS NOT BENEFICIAL TO A LOW-RISK PREGNANCY ❌
✅What does ACOG say?
“Despite the frequency of its use, limitations of EFM include poor interobserver and intraobserver reliability, uncertain efficacy, and a high false-positive rate (pg. 193).”
ACOG says intermittent auscultation is a “appropriate and safe alternative”✅
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