Talk to Me about Monitoring Fetal Heartrate

[pregnova]

So, I've fairly ambivalent towards monitoring fetal heartrate both in the pregnancy and during the birth. I'd love to hear what others have to say on the subject or what they've personally done. How important is it? What will it tell me about the pregnancy or birth that I wouldn't know otherwise?

Thanks guys!

[rajahkat]

Monitoring will tell you how well the baby is tolerating labor.  It can help you diagnose a problem you might not have any other way of knowing  about like an occult cord prolapse.  It can help you make informed decisions about transferring or seeking additional help.  Knowing that baby is not stressed by getting reassuring FHTs can help calm you if your labor is dragging and you're starting to question if things are normal.  Not having any way to check in on the baby can cause unneeded stress during your labor.

All of that said, I haven't checked FHTs during any of my 5 UCs.  My first baby, I was kind of just flying by the seat of my pants and didn't think much about learning how to check.  My other births have been fast and straightforward, and I haven't felt the need to check but I personally wouldn't go into labor without having a way to listen.

[homemademomma]

Originally Posted by rajahkat 

Monitoring will tell you how well the baby is tolerating labor.  It can help you diagnose a problem you might not have any other way of knowing  about like an occult cord prolapse.  It can help you make informed decisions about transferring or seeking additional help.  Knowing that baby is not stressed by getting reassuring FHTs can help calm you if your labor is dragging and you're starting to question if things are normal.  Not having any way to check in on the baby can cause unneeded stress during your labor.

This. Things like cord prolapse can be deadly if they are not swiftly treated.  For my second birth, I only listened when I went into labor andwhen my water broke. Then when I had some bleeding near the end I listened very frequently until she was born.  My point being, it is perfectly reasonable to limit how much you listen, but it is my personal opinion that listening to heart tones can give you a lot of very important information, and is not something I would want to skip. 

[pregnova]

Thanks ladies. These are sort of the responses I expected. So, it's probably fair to say that monitoring while pregnant is not particularly necessary? But, it's a good thing to have access to while in labor. I saw online a spot where you could rent a monitor on a monthly basis...maybe that is worth pursuing as the pregnancy progresses then. 

[rainbow_mandala]

I think it comes down to what you'll feel you might need for peace of mind.  I didn't monitor fetal heart tones during labor because of my strong intuition.  There's a lot of emphasis on checking and monitoring women and babies while in labor, which suits a lot of people...I err on the side of less is more because if my mind is wandering towards "I wonder how the baby is doing" then that's typically a sign that I'm either in transition, I need to change positions, deepen or change my breathing pattern, deepen my trust in my intuition (which would tell me if medical attention is needed), or all of the above...checking the heart tones would just distract from what is *truly* needed in that moment.

[MeTooMama]

I was told by the midwives advising us on our first UC that cord prolapse happens more often when the sac is ruptured prematurely. Especially when it's ruptured for the sake of induction. I didn't check with our last two but I still think it might be nice to have a doppler of some sort. I think when you're on your fourth kiddo you can have a better chance of telling something is wrong than your first but that could just be my wishful thinking.

[pregnova]

Originally Posted by rainbow_mandala 

I think it comes down to what you'll feel you might need for peace of mind.  I didn't monitor fetal heart tones during labor because of my strong intuition.  There's a lot of emphasis on checking and monitoring women and babies while in labor, which suits a lot of people...I err on the side of less is more because if my mind is wandering towards "I wonder how the baby is doing" then that's typically a sign that I'm either in transition, I need to change positions, deepen or change my breathing pattern, deepen my trust in my intuition (which would tell me if medical attention is needed), or all of the above...checking the heart tones would just distract from what is *truly* needed in that moment.

I appreciate this post. This makes a lot of sense to me although I can also see the peace of mind gained by having a monitor in the house at all.

My last labor was very long. Nearly 3 days...and while I feel confident that I (personally) won't feel the need to check heart rate if the labor goes quickly and smoothly, I have been wondering how it would feel if I end up with another drawn out labor. In that case, hearing a good heartbeat might be all the motivation it takes to get things going again. 
 

[rainbow_mandala]

Originally Posted by pregnova 

I appreciate this post. This makes a lot of sense to me although I can also see the peace of mind gained by having a monitor in the house at all.

My last labor was very long. Nearly 3 days...and while I feel confident that I (personally) won't feel the need to check heart rate if the labor goes quickly and smoothly, I have been wondering how it would feel if I end up with another drawn out labor. In that case, hearing a good heartbeat might be all the motivation it takes to get things going again.  

That makes sense...my son's birth was about 8 hours, my daughter's birth was about 6 hours.  I bet if either had gone for more than a day I probably would have felt like some tangible reassurance would be helpful for peace of mind.  Like you said, sometimes all you need is to know everything is okay to help motivate you and deepen your trust in the process.  My births were so quick that I didn't have many moments of wondering how the baby was doing, but in the case of labor going on for days, that's a lot of breaks that make things like checking fetal heart tones being something that adds to the process rather than take away or distract.

[IwannaBanRN]

I am honestly against continuous monitoring of low-risk laboring women. I don't think occasional checks with a fetoscope before, during and after a contraction is very invasive. Not nearly as invasive as being strapped to TWO monitors that slip all over the place while you're trying to move through contractions and being told to lay still on your back so they can get good strips on your contractions and baby's heart rate. EFF THAT!

[homemademomma]

Originally Posted by IwannaBanRN 

I am honestly against continuous monitoring of low-risk laboring women. I don't think occasional checks with a fetoscope before, during and after a contraction is very invasive. Not nearly as invasive as being strapped to TWO monitors that slip all over the place while you're trying to move through contractions and being told to lay still on your back so they can get good strips on your contractions and baby's heart rate. EFF THAT!

I completely agree! I am 100% in favor of intermittent monitoring, and I DO think monitoring in pregnancy is also important. But CEFM for low risk women is a load of crap.

[BaileyB]

Originally Posted by IwannaBanRN 

I am honestly against continuous monitoring of low-risk laboring women. I don't think occasional checks with a fetoscope before, during and after a contraction is very invasive. Not nearly as invasive as being strapped to TWO monitors that slip all over the place while you're trying to move through contractions and being told to lay still on your back so they can get good strips on your contractions and baby's heart rate. EFF THAT!

Hey. Just lurking....are FHT's easy to hear with a fetoscope? I want to get one but didn't want to waste my money.

[Right of Passage]

I have no issue finding FHTs with my fetoscope, it is a far better sound than a doppler. Also I have the peace of mind knowing I'm not shooting soundwaves (Which we don't know WHAT it will do) at my baby. And a fetoscope, a basic one, costs $15, pretty darn cheap and worth it.

[IwannaBanRN]

You know what's funny is that most OB's these days haven't even SEEN a fetoscope or held one. I had to describe to my OB what one looked like.

[PinkorBlue11]

Originally Posted by IwannaBanRN 

You know what's funny is that most OB's these days haven't even SEEN a fetoscope or held one. I had to describe to my OB what one looked like.

Wow, that's a shame.. I guess I would be in for a bewildered OB if I asked to be checked with a fetoscope instead of a doppler. :P
 

[IwannaBanRN]

Originally Posted by PinkorBlue11 

Wow, that's a shame.. I guess I would be in for a bewildered OB if I asked to be checked with a fetoscope instead of a doppler. :P
 

I requested one while going over a birth plan(that I wouldn't use because I planned on staying home lol) and he was like "uuuhhh... what does one even look like?" haha
 

[WaitingForKiddos]

I'm not an UC'er but... my OB (who is attending our homebirth) listens to the baby during prenatals to 'get to know her'. So he can see what are her typical heart tones are and then know if she's not handling labor well for some reason. And he knows what a fetoscope looks like. 

[IwannaBanRN]

Originally Posted by WaitingForKiddos 

I'm not an UC'er but... my OB (who is attending our homebirth) listens to the baby during prenatals to 'get to know her'. So he can see what are her typical heart tones are and then know if she's not handling labor well for some reason. And he knows what a fetoscope looks like. 

I've never heard of an OB attending a homebirth unless his wife happened to be the one having the baby.

[WaitingForKiddos]

We have an awesome OB out here who got sick of the hospitals not allowing him to offer VBACs and breech births so he left and started doing homebirths.Given the crappy birthing climate it is so nice to have options. 

Here is his blog and website...

http://www.supportdrfischbein.blogspot.com/

http://www.birthinginstincts.com/

 

[PinkorBlue11]

Originally Posted by IwannaBanRN 

I requested one while going over a birth plan(that I wouldn't use because I planned on staying home lol) and he was like "uuuhhh... what does one even look like?" haha
 

LOL

WaitingForKiddos~ I've heard of him and seen him on More Business of Being Born, he does sound like an awesome OB. Good for him standing up for what he believes is best! Happy homebirth wishes to you! :)

[homemademomma]

The only thing that is a drag about using a scope during labor is that you can't be in the water, you have to be t least semi-recumbent, and everyone has to be very silent and you have to be VERY still while you or the MW (or whoever) is listening. Otherwise it is difficult to hear the nuances that are important to pick up to determine your baby's well being- variability, etc. I used scopes during my pregnancy and a doppler during labor, because it was SO much less invasive to have a quick listen with the doppler, as opposed to the whole production of a scope. I have attended women who only wanted a fetoscope in labor. It was a huge PITA for the mom, and i am quite skilled at using a scope. I imagine it would be very difficult to use in labor for someone who isn't familiar with it.