ok to use doppler during labor?

[DKPA]

So I had no idea at the beginning of my pregnancy that there were risks involved with ultrasound and doppler use; no one bothered to warn me before using them on me and I just hadn't gotten there in my research yet.  It's my first baby and everyone i know gets ultrasounds so i thought nothing of it.  So after having an ultrasound to date the pregnancy and using the doppler at 3 visits, I kind of had a meltdown when i read the risks and haven't had an ultrasound or used doppler since.  I asked one of my midwives if she'd use the fetoscope during labor but she said it was their policy at the birth center to use only doppler at that point.  Should i be worried?  

[Thing1Thing2]

There isn't much out there as far as research is concerned. The effects of ultrasounds have never been tested. No one can say they are completely safe, but on the other hand no one can say for sure that they are totally unsafe. This is just one of those decisions I had to go with my gut for.

After reading a few articles, I have decided that I'm most likely not going to get any ultrasounds done for this pregnancy.

As for the doppler, I have weighed the risks and since the frequency is at a much lower, less invasive level, I will probably allow my MW to use the doppler.

I feel that the doppler is quick and easy way to hear the heartbeat and make sure the baby is ok and the benefits outweigh the risks for me. Ultrasounds, on the other hand, have no real medical value to me.

[tzs]

for me it's (u/s) something we just don;t know enough about to be sure. but just like i can't be sure it's 100% safe, you also really can;t say that it's 100% dangerous. i take it as a risk/benefit decision. like, tylenol is safe to take during pregnancy, right? but you still wouldn't take it of you didn't need to. 

i personally try to avoid ultrasounds unless there's a medical reason (in my case i take a class C medication so i do consent to a 20 week scan to check for heart defects) but i do allow a quick doplar. i've considered going the fetoscope route this time and my OB was willing but it looks like i might have some other issues that are going to merit at least one more U/S so i think i might just go with the doplar.

in a perfect world my choice would be to do zero U/S ore doplar but i also wouldn't feel like i was doing incredible harm if i felt like i would benefit from it medically.

IMO it's a very individual choice based on your circumstances.

long story short....i wouldn't worry. anxiety can do way worse for you than a few doplar scans. good luck!

[Full Heart]

For me I simply was not moving to a position in which my mw could listen with a fetoscope.  I feel the benefits far outweigh any risk.  Its difficult enough for me to have a doppler pressed against my belly during labor, esp during a contraction, there is no way I was allowing a fetoscope.  Of all things, thats the least of my concerns honestly.

[DKPA]

Thanks for the replies.  i agree the research is really inconclusive but it seems like doppler use during labor isn't going to be the end of the world and you're definitely right Full Heart, with the active labor I'm hoping for, using a fetoscope would be really difficult.  

[HappyMonkey]

I had them use the fetascope during my appointments, but happily allowed the doppler during the birth so I didn't have to move into positions for them to check with the fetascope. It takes alot longer than the doppler and I felt good knowing the heart rate was good. I think it's all about minimizing when not needed, but in cases where it helps allowing. That's how I went anyway. I didn't have any ultrasounds, but would have considered it if there was a concern (a real one).

[TinyFrog]

I have avoided all US and doppler use so far but the midwife will use a doppler during labor.  The thought really bothered me at first but I am ok with now as is It will be pretty minimal.  If given the choice I would probably choose a fetoscope during labor, but it is not an option with my midwife either.

[DKPA]

I guess i just hope they won't be checking the HR constantly, i feel like that will cause more anxiety than anything else.  I've never done this before, how often do they typically check in labor?

[MegBoz]

Originally Posted by DKPA 

I guess i just hope they won't be checking the HR constantly, i feel like that will cause more anxiety than anything else.  I've never done this before, how often do they typically check in labor?

This varies really REALLY widely & you'll need to discuss with your HCP. Most hospitals do continuous EFM for all, or most laboring women (or they do continuous once they've had an epidural, which is the majority.) Otherwise more NCB-friendly hospitals generally want a 20 min strip when you first check in in labor, then 15 min sitting on the monitor every hour is "policy." However, my MWs (hospital CNMs) were open to using doppler, and obviously no one is going to hold a doppler there for 15 solid, consecutive minutes every hour!

I'm fairly sure ACOG policy is to check FHT every 30 min in 1st stage labor. My MW now - an HB MW, CPM, says she'll check every 15 min - I'm considering requesting that go down to every 20-30 min during 1st stage as long as FHT are good. I'm not sure how long they hold the doppler on - maybe a few min? I know they want to hear FHT during a ctrx, then hear how it recovers post crtx. The rate at which it recovers is important too, so they need to listen for more than just like 15 seconds like they do at a prenatal apt.

I just read the US chapter in the book, "Gentle Birthing/Gentle Mothering." It wasn't convincing to me at all. Lots of theories on how the waves effect cells, followed by research on mice, rats, and cells in petri dishes. They did finally get to some human studies, but I still don't worry about it at all.

I had my DS in a hospital & one of the MWs told me they check FHT after every push. A nurse ended up holding the little EFM monitor on me the whole time I was pushing, but it didn't bother me in the least. I barely noticed it - and DS did have some decels that concerned the MW. she had me get down from H&K onto my left side which resolved it. Making sure his HR was healthy absolutely outweighed the "risks" of doppler - particularly considering I don't view it as very risky anyway.

[HappyMonkey]

They only need to hold it in place a few seconds to my memory of my last birth.

[DKPA]

wow every 15-30 minutes sounds like a lot...

[HappyMonkey]

In early labour for me it was only every hour or so.. just more regular during the actual pushing phase.

[prothyraia]

Originally Posted by HappyMonkey 

I had them use the fetascope during my appointments, but happily allowed the doppler during the birth so I didn't have to move into positions for them to check with the fetascope. It takes alot longer than the doppler and I felt good knowing the heart rate was good. I think it's all about minimizing when not needed, but in cases where it helps allowing. That's how I went anyway. I didn't have any ultrasounds, but would have considered it if there was a concern (a real one).

This.  We had no ultrasounds or doppler during pregnancy with my second, and while my midwife usually does use a fetoscope in labor it was too difficult for me to get into position long enough for her to do so (darn noisy anterior placenta didn't help, either...).  At that point, I think the benefits of being able to move freely and also monitor the baby's heartrate outweighed any theoritical risks.

Overall, with ultrasound, I'm in the "They are probably fairly safe but there's no sense in doing them unless you have a good reason" camp.