Are you planning on continuous fetal monitoring???

[cinderella08]

Alot of what I hear and read mentions that using fetal monitoring (continuous external monitoring) is one of the earliest indicators of a uterine rupture because the baby will have heart decels or appear to be in distress or react to the rupture.

Are you VBAC mama's planning on allowing continuous EFM or are you still planning for intermittent monitoring?? Has anyone done alot of research on this??

I really, really, really would prefer just intermittent monitoring so that I can labor in the shower, walk, ect... as I please - but wondered how much truth there was to it being a clear indicator of a rupture.

[CherryBomb]

I wound up doing it. By the time I got to the hospital I was 7cm and didn't want to get up and walk, anyway, which would be my only reason for not wanting CFM.

[Monkey Keeper]

I don't think this is the hill I want to die on, so probably. But I'm really, really hoping I can get my OB to write orders for telemetry monitoring. I tried to get it last time, but it was super busy in L&D. I think maybe if she writes specific orders for it, I'll have to fight with the nurses less...

[cinderella08]

Our hospital is equipped with a huge jacuzzi tub in each L&D room, so I'm hoping to get to use it to labor in... which I can't do with the monitor....

BUT, if this is the only battle I lose, I'll be ok with that too...

[buckeyedoc]

There are only two things my hospital requires for VBACs: CEFM and a heplock. I plan to labor at home for a long time with my doula and will check my own cervix. I don't think I have the mental energy to fight the CEFM, but it will have to come off for me to use the bathroom, which I might do all the time! And I will still sit on my birthing ball while wearing it. I do plan to talk to my provider ahead of time about what things are truly concerning on CEFM vs. not, because I don't want to be talked into a fetal distress C-section only to find out my baby is totally healthy and fine.

[cinderella08]

Originally Posted by buckeyedoc

There are only two things my hospital requires for VBACs: CEFM and a heplock. I plan to labor at home for a long time with my doula and will check my own cervix. I don't think I have the mental energy to fight the CEFM, but it will have to come off for me to use the bathroom, which I might do all the time! And I will still sit on my birthing ball while wearing it. I do plan to talk to my provider ahead of time about what things are truly concerning on CEFM vs. not, because I don't want to be talked into a fetal distress C-section only to find out my baby is totally healthy and fine.

See, this is my exact fear too I understand there are REALLY cases of fetal distress, but there are also TONS of cases where it's really not distress and leads to an unnecessary section.

I'm going to consent to the heplock because really, I'm ok with it - doesn't much bother me at all.

[LisaSedai]

It was required in the hospital where I delivered. It really didn't bother me too much, though toward the end my doula said lets get up and go to the bathroom and I disconnected for a while. Doc fussed slightly at this but not a graet deal. It would have concerned me more if I hadn't have had the Dr I did. I trusted his ability to read the strips correctly- some people see fetal distress where there isn't any/overeact. That's why the use of fetal monitoring has led to an epidemic rate of c/s.

Some hospitals have wireless #waterproof# fetal monitoring.

[cinderella08]

That's something I need to call L&D and ask about. If they have telemetry units that can still do continuous monitoring while allowing me to be as mobile as I'd like - especially allowing me to walk. And waterproof would be a-mazing!

[dlm194]

I consented because my hospital had the wireless/telemetry monitors that allowed me to walk around and use the tubs, showers, etc. I also consented to the saline lock IV access port.

[sharr610]

I was all fussy about this before labor but it turned out to be no big thing (for me at least). After I was in labor, I got the absolute lowest dose of pitocin to regulate my contractions. With pit, your body won't slow down the contractions and the CFM can be really important to catch early rupture with stronger contractions. So I accepted it. BUT, I had waterproof telemetry units that wouldn't stay put. BUT my birth team and nurses rocked it and I just moved wherever I wanted and they held the units in place until the very end when we went to internal monitoring, which, again, allowed me total mobility.
As long as you can move however you need and you aren't with a totally over reactive doc, I say its not a biggie.

And I was planning an HBAC, totally against all hospital policies, etc...had a GREAT VBAC.

[changingseasons]

Originally Posted by PinkBunch

I don't think this is the hill I want to die on, so probably.

What on earth does that mean?! That if you don't have EFM that you (or your baby) will surely die in labor?

I'm planning a HBAC, so no EFM for me. Midwife will use a doppler during labor.

[AlexisT]

Hill to die on isn't a literal expression. Just means that it's not what you're going to invest your resources in.

I plan on EFM, but this is as much because I have high blood pressure as because I'm a VBAC.

[frenchie03]

I had EFM with my first (ended in c-section but not for fetal distress) and it wasn't a big deal. I took it off to get in the tub, was out of the tub 30 min. later and it went back on. I didn't even notice it. If that's possible this time around that's what I'll do. I'm sure they'll want CFM this time but there is a balance to be struck between actually laboring and moving around and being safe and in touch with how the baby is doing. I trust my doula to help us strike such a balance with the staff at the hospital. I should add that the first time I had an IV in place and THAT was much more hindering than the fetal monitor. I hope to just get a heplock this time.

[Monkey Keeper]

Originally Posted by AlexisT

Hill to die on isn't a literal expression. Just means that it's not what you're going to invest your resources in.

This Just another way of saying I'm going to try to choose my battles, and I'm not sure this is one that I will pick to fight, particularly if I can get telemetry units. For my personal situation, I agree with frenchie's 'strike a balance' approach!

[mollikins]

I had continuous monitoring with my vbac once I got past 6-7 cm. The hospital had a telemetered unit so it was no big deal, I got to be up and moving around and was comfortable (as you can be during labor). Once I got to the pushing phase they ended up putting a monitor on DD'd head, b/c she was turned funny and they kept losing her HR with the belly unit.

It all worked out, if I have another I'll probably do the same.

[MaddieMay]

I'm hoping for a telemetry unit, but need to ask if the hospital has those. I'm planning on going to the hospital very, very late so hopefully it won't be an issue. It may become a battle I fight, though because I NEED to be able to move while in labor. If I don't feel like moving (doubt it), then they are more than welcome to do it.

[mrsberman]

I am also hoping for a telemetry unit. If there isn't one then I will ask for intermitent monitoring. Also, I am planning to hold out at home as long as possible at home. Last time I wanted to move around and I felt like I was on a 5 ft leash. This time I plan on moving more. Also, I don't think I could ever agree to internal monitoring. Creeps me out.

[sattygirl99]

Originally Posted by buckeyedoc

There are only two things my hospital requires for VBACs: CEFM and a heplock. I plan to labor at home for a long time with my doula and will check my own cervix. I don't think I have the mental energy to fight the CEFM, but it will have to come off for me to use the bathroom, which I might do all the time! And I will still sit on my birthing ball while wearing it. I do plan to talk to my provider ahead of time about what things are truly concerning on CEFM vs. not, because I don't want to be talked into a fetal distress C-section only to find out my baby is totally healthy and fine.

This happened with my daughter... She compressed her cord during transition (basically it came down next to her head, not prolapse, just up against her ear) and her heart rate dropped and then skyrocketed because I transitioned (7 and 0 to 9cm and +1 in about 90 seconds). They declared fetal distress and I ended up with a c-section on the premise I must be at risk for rupture. When they got in there, the OB asked who it was that did my prior section because my scar was nearly invisible and completely strong. So I ended up with a c-section I didn't need... What happened to us, happens in most labors during a hard and fast transition but is often 'missed' because there isn't any EFM.

Even the ACOG states that EFM doesn't change the outcome of birth. I would never consent to it again... Ever.

[Melly24]

EFM is what started the downhill slide to my c-section with DD, so no way am I consenting to it again. My midwife will use a handheld doppler intermittently during labour.

[cinderella08]

My greatest fear is being bullied into a RCS just because of claimed "fetal distress" - I know that's commonly misinterpreted. But then again, I also do know fetal heart tracings can be the earliest indicator of a rupture and while I *KNOW* the UR risk is MINIMAL, I can only see blaming myself had I refused continuous monitoring only to be in that small percentage who experiences a rupture.

That being said, I do still plan on refusing continuous monitoring but plan to be monitored frequently during labor.