Did your ob require continuous monitoring?

[paintedbison]

Just trying to figure out how common it is to not allow a low risk woman to get out of bed or off monitors at all...

[Veritaserum]

Yep. Most OBs and hospitals around here require it. A small handful of practices are willing to do intermittant.

[cschick]

Originally Posted by paintedbison

Just trying to figure out how common it is to not allow a low risk woman to get out of bed or off monitors at all...

My OB didn't--the hospital did. While the hospital claimed they "allowed" intermittent monitoring, what you learned is that there were so many exceptions to that rule that almost all women were on continuous.

My water was broken, so they required continuous monitoring. Which I couldn't bear, so I tore half of it off. (I tore off the contraction monitor, which was on the bottom of my belly and left on the fetus heartrate monitor.)

And the L&D nurse who told me it was required revealed herself to be perfectly capable of tracking contractions and their intensity without the cursed thing.

[lifeguard]

I didn't have it at all - they did one session near the beginning of labour & when I practically tore the thing off frantic to get out of bed they never tried to strap it on again. But I think it was more to do with my ob then the hospital as there were several hospital policies that didn't apply to his patients - like delivering a regular room instead of a delivery room.

[layla983]

It's required here. I even went in at 39 weeks to moniter my BP (I had one semi-high reading at my OB's office, nothing after that, but they still insisted I go to the hospital for a few hours which I agered to just to get them off my back) & I was STILL strapped into bed on fetal moniters for those 12 hours, where there were no fetal problems at all. Of course I was also not allowed to eat the entire time either. I was told it was hospital policy, that if I was laying in an OB bed I had to go by their OB policies. Loads of fun.

[BugMacGee]

Nope. Not until I got epidurals.

[applejuice]

Did you know that the electronic fetal monitor (internal and external) was developed for use ONLY on high risk women, and the man who developed that contraption decried its use on ALL laboring women in hospitals.

Yet, there it is!

[Equuskia]

With my first birth, I was on continuous monitoring despite having no risks. Which is why I stayed home the second time.

[woodchick]

I was monitered once when I arrived at the hospital maybe twice during the next 6 hours and then with an internal moniter due to DD's unexpected complications. But the internal monitor was only for 15ish minutes before she was born.

So, I'd say no, neither my OB (nor the hospital) required continuous monitoring during normal labor.

[Mommal]

In my neck of the woods, intermittent monitoring is the standard for low-risk women. However, I've talked to a number of moms who ended up with near-continuous monitoring due to hospital policies/errors/interventions. For example, one friend who was told "We just need a 20 minute strip every hour" and then ended up on near-continuous monitoring because her contractions stopped every time she law down for the monitor, and consequently it took waaay longer than 20 minutes to get a strip.

You do not have to acquiesce to continuous EFM. You can say no! That is your legal right as a patient. However, if you say "no" and your doc says "I'll dump you from my care if you won't" then s/he's doing you a favor, because s/he's not the doc for you. If s/he can't respect your birth choices when it comes to the little things, s/he's not going to respect them when it comes to the major issues.

[Belle]

Amazingly enough. I got my OB to agree ahead of time to only intermittent monitoring. And it actually happened. The nurses that I had were angels and suggested that I get into the bath. When the on-call OB showed up she made me get out of the bath, but she didn't insist on continuous monitoring.

[alison_in_oh]

The hospitals I've been in contact with seem to prefer continuous monitoring. I toured L&D last week where I'll be delivering and the nurses' station had a huge bank of monitor readouts. : My current midwife is all blithe and says, "MY patients don't have to have continuous monitoring!" but she still wants 20 minutes out of every hour -- she's not getting it. They can have a 20 minute intake strip, and that's it. If they want to check the baby they can use a handheld fetoscope. I'll take the damned belt off and stay in the water if they get pushy about it.

[earthmama369]

I didn't have an OB -- I went with a family practitioner -- but neither they nor the hospital required continuous monitoring. With dd, my water broke before contractions started, I was GBS+, she was my first (i.e. I was "unproven"), and my labor went longish (23 hours)...all the classic "reasons" for intervention if a doctor or hospital were so inclined...and they still only asked for monitoring every 4 hours for 15 minutes and encouraged me to walk, walk, walk, and change positions a lot. And with ds, when I said I didn't even want that, they said fine and the doctor came in every couple of hours or so to listen for a minute with a handheld wrapped in plastic (I was in the water), and he just worked around me in whatever position I was in after asking permission each time.

That's the long answer. The short answer is no.

[Kidzaplenty]

Yes, it was required for me. I did have a pit induction. I "could" have taken it off after I stopped the pit, but by that time, I just did not think about it. If there is ever a next time, I will refuse it or remove it when the time comes.

[MegBoz]

I was seeing some OBs who deliver at world-renowned Johns Hopkins hospital & the nurse in the office told me continuous EFM was required.

I switched practices to a smaller county hospital & even on the tour of the L&D ward, the nurse said they do 20 min every hour. But they have a pool for Mamas to labor in, so I believe they'd also be fine with just doppler readings intermittently.

I ended up arriving already through 1st stage, so I didn't get to see how they do it in reality.

Since continuous EFM does NOTHING to improve outcomes for low-risk birth and ONLY increases the intervention rate, the Canadian OB/GYN society actually recommends intermittent for low risk birth.

[bella99]

I was on the monitor for the first 10-15 minutes after I was admitted. Then it was removed and I was occasionally checked with a doppler.

That was it.

[wombatclay]

DD1 (family practice dr) - 20 minute strip on arrival, no monitoring until many maaaaaaany hours later when I got a spinal prior to the c/s. Oh, my water broke hours before contractions began and there was no problem with my using the labor tub or requests for additional monitoring.

dd2 (with an OB and keeping in mind I was a vbac mama)- 20 minute strip on arrival, no monitoring until pushing when it was a "quick listen" via doppler every 15 minutes. I pushed for almost 4 hours so there were a lot of quick listens, but I honestly didn't really notice them. Again, my water broke before I arrived at the hospital and again I was able to use the tub and there was no "extra" monitoring.

babe 3 on the way (midwife) - planning an HBAC, so no 20 minute strip this time. I'll have a doppler listen every 15 minutes during pushing again though.

[AlexisT]

#1 - had EFM as I was admitted to hospital with severe preeclampsia. Otherwise would not as it's not NHS protocol for low risk women. (protocol is IA with fetoscope or doppler, switching to EFM if there are any problems). Had CS based on suboptimal CTG (actual wording on my paperwork!)--often this is kind of a bogus reason but in my case the best choice given the context (severe preeclampsia, urine output decreasing, cervix unfavorable for induction).

#2 - will be some form of EFM though I will insist on breaks (my personal comfort zone for VBAC).

The thing to keep in mind is that in many hospitals cEFM is easier on the nurses and that's why they want it (hospitals don't maintain good staffing ratios and hospitals can use central monitoring so strips can be reviewed in one place). If staffing is really bad, they may not even be able to perform IA correctly, because they don't have time. (Obviously, this should not be the case, but sometimes it happens.) As much as you need your OB to be on your side when it comes to issues like EFM, the nurses are the ones who can make or break you, so check out the hospital and find out how the nurses work. This is also why, if you're going to give birth in the hospital, a CNM who shows up for most of the labor is really helpful.

The other thing to check out is whether telemetry monitoring (wireless) is available--and check with the OB and people who have given birth because I've heard of hospitals that claim to have it, but don't make it available. This improves mobility if you do need EFM, and at least keeps you from being stuck in bed.

[spu]

I've had 3 births at two different hospitals.

First was a planned induction (dumb...) - so I was confined to bed, constant monitoring (pg with twins...).

Second was a planned vbac (turned c). I had an internal monitor (my choice) and was allowed to move around as much as I wanted - brought the monitor with me.

Third was a planned vba2c (successful!) - I arrived ready to push, so I chose an internal monitor so I could move as I felt without worrying about the cumbersome belts.

I actually felt peace with the IFM - they can turn the sound way down, and conceal it behind a closet door, so there's nothing to stare at when someone comes in. I've read so much about issues coming up, and for me, it was reassuring - not scaring... I felt peace with the rise and fall of the hearbeats in conjunction with the feelings of contrax and pushing that I was experiencing. It worked and gave me more power to push more confidently.

I couldn't imagine being confined again. i wouldn't allow it unless there was a real medical reason. Nurses like to keep us quite and keep us put - less work for them. I believe it makes for a more traumatic or unnatural birth experience.

[mom2L]

My OB doesn't, and I'm a vbac. He's rare though. But, my birthing center doesn't require it either for low risk, and they go along with what the doc wants for the high risk births.