I am not a MW, L&D Nurs or MD. As a doula, fetal heart rate assessment is out of my scope, but I had a couple brief comments and would love to hear from those who do use these as an assessment tool in labor.
1. I have seen and read how so many people can interpret the information seen on a strip of FHR differently, and studies have shown the huge range of interpretation and diagnosi when people have been shown the same strip..
2. Sometimes, it seems that everyone is so focused on what the machines are saying that no-one focuses on the labor and mom!
3. We have only been "looking" at FHR in such detail in the past how many years? (first external monitor is how old?) But maybe, just maybe, some of the things that cause concern have been normal and happening for a million years, and babies are designed to handle it just fine!
4. I have been at birth where, one dip into the 70's and we on our way to surgery, and at another with a different nurse and doc, and they are happy with hours (7-8 hours) of the same dip, with every ctx..."oh, just cord compression, no worries"
5. It is more than how low does it go, but, for how long, how does the baby recover, how quickly does the baby recover, what is the baseline, are there any accelerations too? is it just flat, has the baseline changed, when is the decel compared to the ctx and many other subtleties that others can elaborate on...
6. Many reliable and accepted studies have shown that continious FHR monitoring does not provide more information or a better outcome than intermittent monitoring and is often the reason for unnecessary interventions. See item 3 above...
7. I hate having the machine play such a big part of my clients' labor and encourage them to keep the sound off and the machine turned away from them, so we can labor and proceed using the cues and needs of mom as our guide.
Will appreciate others' comments on this thread!
Birth doula, doula trainer, ican leader, lamaze childbirth educator, and most importantly, mom of 2 great girls!