Benefits of Intermittent Auscultation?

[rparker]

I understand why EFM is undesirable. But what are the benefits to intermittent auscultation with a fetoscope or doppler during a low risk labor? Also...

-Are the ACOG guidelines for auscultation--i.e. every 30 minutes during the 1st stage and every 15 minutes during the second stage--overly cautious?

-Is auscultation during a contraction necessary or could it be done between contractions and still produce useful information?

-How often and to what degree is auscultation used during midwife attended home births?

Backstory: My 1st labor was short (3 hours at home, 3 in the hospital) and pretty easy, but I absolutely hated the 2 times I agreed to intermittent EFM (upon admission and while pushing) and even the intermittent auscultation with a doppler really annoyed me. (The nurse used the doppler 2 or 3 times.) A home birth is not an option for me where I live, so I'll be having another hospital birth. My current provider agreed very quickly and easily to no EFM and informed me the hospital had an alternative protocol for intermittent auscultation. I haven't asked him to define the hospital's definition of "intermittent" yet, but I suspect that it's going to be more intrusive than I'm comfortable with

Thanks in advance for sharing your perspective either way!

[CherryBomb]

Well, the benefits of intermittent auscultation are improved fetal and maternal outcomes, without the increase in c/s you see with continuous fetal monitoring. I don't think this is an area where most hospitals are going to bend much. Your hospital's guidelines for intermittent ausculation are probably going to be in line with the ACOG guidelines.

I would say you could probably ask them not to do it during contractions, though if they see the baby's heart rate getting wonky, they'll probably insist on doing that to get an idea of how baby is handling the contractions.

How it's used during homebirth probably depends a lot on the individual mw and the mom's preferences.