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The tocometer (which is the monitor that monitors contractions) works as a simple pressure change monitor. It detects changes in pressure. A contraction shows up usually as a smooth hill - pressure gradually increases, peaks, and goes back down gradually. It is the heart rate monitor that is ultrasound. An external contraction monitor also picks up other pressure changes - you will see spike type things with movement, or sometimes see small bumps with each breath. An external monitor can only tell when a contraction is happening - not how strong they are. How high the pressure change registers has to do more with the shape of the mama, where you put the monitor on her belly, and a lot of external factors like that. Sometimes, particulary with fluffier moms, it's hard to trace contractions at all if you can't get the monitor situated well over the uterus. It is not at all uncommon to see huge-looking contractions that one woman can barely feel or not feel at all, and have another woman in active, active labor with contractions that visually barely measure anything. Sometimes, care providers get caught up thinking someone must be laboring because contractions are tracing, or someone must not be laboring because their contractions don't trace or look small. It's important to remember that the monitor can only tell you when a contraction is happening, not anything about it's strength.
An internal contraction monitor (called an intrauterine pressure catheter, or IUPC) can usually accurately measure the strength of a contraction.
After 4 m/c, our is here!
Next time you see one, look at it, touch it, flip it over and see the little button on the mom's side. If it's attached, and you touch the button (depress it), it will read the pressure. That's all it is. There are electronics to interpret in the input, but it's a button on a strap.
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