Talk to Me about Monitoring Fetal Heartrate - Mothering Forums

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#1 of 33 Old 09-30-2011, 03:43 PM - Thread Starter
 
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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?

 

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#2 of 33 Old 10-01-2011, 05:14 PM
 
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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.


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#3 of 33 Old 10-02-2011, 05:43 PM
 
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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. 

 


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#4 of 33 Old 10-03-2011, 05:13 PM - Thread Starter
 
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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. 

 

 


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#5 of 33 Old 10-04-2011, 10:15 AM
 
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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.

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#6 of 33 Old 10-04-2011, 01:52 PM
 
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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.

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#7 of 33 Old 10-04-2011, 07:32 PM - Thread Starter
 
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Originally Posted by rainbow_mandala View Post

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. 
 

 


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#8 of 33 Old 10-05-2011, 11:03 AM
 
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#9 of 33 Old 10-05-2011, 02:33 PM
 
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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!

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#10 of 33 Old 10-07-2011, 11:49 AM
 
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Originally Posted by IwannaBanRN View Post

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.

 


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#11 of 33 Old 12-02-2011, 09:31 AM
 
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Originally Posted by IwannaBanRN View Post

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.

 


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#12 of 33 Old 12-04-2011, 03:45 AM
 
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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.

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#13 of 33 Old 12-12-2011, 02:51 PM
 
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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. headscratch.gif

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#14 of 33 Old 12-12-2011, 06:04 PM
 
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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. headscratch.gif


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
 

 

 


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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
 

 

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#16 of 33 Old 12-12-2011, 09:17 PM
 
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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. thumb.gif


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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. thumb.gif



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

 

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#18 of 33 Old 12-13-2011, 08:16 AM
 
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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/

 


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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! :)

 

 

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#20 of 33 Old 12-26-2011, 11:49 AM
 
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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.

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#21 of 33 Old 01-10-2012, 05:29 PM
 
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This is something that I have also been thinking on in case I end up doing my partial-unassisted. I'd want a waterbirth so is a doplar better for that? Or can you use a fetoscope as long as your high enough out of the water that your belly's not under?

 

Here is the section on FHT monitoring from Ina May's Spiritual Midwifery:

 

"Baby's heartbeat should be checked and recorded every half hour during the first stage [of labor]. Always check if you have even a slight question in your mind about how the baby's doing. Then you can either dismiss the question or fix the situation. The normal heart rate is 120-160 beats per minute. The heart rate becomes slower at the onset, or sometimes the height, of a rush [Ina's term for contractions] and returns to normal by 10-15 seconds after the rush. A heart rate of less than 100 or more than 160 bpm with the uterus at rest suggests that the baby is in trouble. The baby's heart rate is somewhat harder to hear during a rush because the uterus is thicker, so check the heartbeat between rushes. A marked increase in the heart rate is the first sign of hypoxia, and also a sign of possible intrauterine infection of the baby. A slow heart rate or one that does not recover to normal after a rush always indicates fetal hypoxia and can be a sign that the cord may be compressed. Changing the mother's position especially if she has been lying on her back, often helps the baby's heart rate return to a normal pattern."

 

Btw, I would highly recommend reading that book. I just ordered her Guide to Childbirth as well.

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#22 of 33 Old 07-10-2012, 08:59 AM
 
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It depends on how highly you prioritize knowing that your child is alive, and their condition at a given moment so you can take action to save them if they start losing oxygen.. If that information wont change your decisions, it is irrelevant.

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#23 of 33 Old 07-10-2012, 10:16 AM
 
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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!

Personally I wouldn't normally pull out a fetoscope or doppler in labor. I rather monitor kick counts, something I do throughout. And I'm not really "counting" as much as noting a normal amount of fetal movement, because at that point you become pretty aware of what is normal vs less than normal.

 

I think I would use the doppler on the presenting baby between births if having multiples. Time will tell what I decide, as you all know I think there's more than one on board. I'm not really concerned that I'll have any issues with a low stress pregnancy and optimal maternal nutrition. My babies have always had agpars of 10.

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#24 of 33 Old 07-12-2012, 11:34 AM
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I've seen a few posts in the UC forum lately that make me feel the need to remind everyone of the forum guidelines:

 

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The Unassisted Childbirth (UC) board is a forum of support, respectful requests for information and sharing of ideas and experiences. While we will not restrict discussions only to those who birth without professional attendants, we will actively discourage individuals from posting with no sincere interest in exploring UC. Proselytizing against UC will not be permitted. Controversial subjects of discussion related to UC can be found elsewhere on the internet, and we invite you to seek out other venues for that purpose.

While we wish to support women throughout the birthing process, we cannot host threads seeking advice during unassisted labor. Labor announcement threads are fine, but any posts seeking advice will be removed. We encourage you to share your birth narrative afterwards in MDC's Birth Stories subforum. Discussions at Mothering.com, MotheringDotCommunity and the Birth & Beyond boards are not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read here. Please see the forum disclaimer here.

It is our goal to maintain a helpful and welcoming atmosphere for everyone. You may contact a Moderator if at any time you are unsure about the Forum Guidelines or if you have any questions, concerns or comments. Please take care to post in accordance with the MDC User Agreement.

Implying that someone does not prioritize their child's life is not respectful, kind or helpful. kgdg Please edit your post so that you may continue to post to this forum. 


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#25 of 33 Old 07-15-2012, 10:37 PM
 
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I had it checked at every OB visit, but we didn't get a doppler or monitor during labor at all. I didn't feel like it would help us, if anything it would distract us and possibly make us worry over nothing. I'm not trained to know what are normal decelerations. If I would have had a midwife or OB deliver, I would have declined all monitoring as well.

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#26 of 33 Old 07-17-2012, 10:56 AM
 
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I've never thought of using one before for a UC - I don't want to become my own midwife.  It seems to me to be checking to see if something will go wrong...

Though, if I "felt" I should, I would.  UC to me is more about going with your gut, than where and how your baby is born.  So if your gut says use one - it's not really a UC to not.

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#27 of 33 Old 09-29-2012, 12:43 AM
 
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I decided to order a doppler with a waterproof probe for my rather unexpected UC.  I guess that's also a sign that I'm still not 100% comfortable with the idea, but it's something that will help me be *more* comfortable with it.  [My plan, all along, was to have a midwife assisted homebirth, but we came to an impasse on GD testing.  I was considering transferring to a hospital based CNM group, but they wouldn't see me unless I did the 3 hour glucola test... refuse (which I had to for my health - not a stubbornness thing) and I was automatically assigned to the high risk OB and diabetes care teams.]

 

So I asked some opinions in a pregnancy community where I knew quite a few moms rented/purchased dopplers.  I found an inexpensive one that I plan to use for the last 8 weeks of my own prenatal care and intermittently during labor.  I have a fetoscope, and I used it successfully during my first 2 pregnancies.  But this time, I'm having a hard time finding the baby's heartbeat with it - no problem at all finding my placenta, though!  I don't plan to use it for fun nor to use it daily - just once every 2 weeks for the next 4 weeks and then weekly until s/he starts labor in his/her own time.  Then I'll occasionally listen through a contraction to make sure s/he reacting well.  Like I said, for me it's a comfort measure - some might even say a crutch.  But I haven't had long to mentally prepare to do this without a birth professional - I'm relying heavily on the support of my husband and a couple friends who have some basic medical training (but not in L&D) to help me though labor and birth at home.

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#28 of 33 Old 10-07-2012, 10:51 AM
 
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I've seen a few posts in the UC forum lately that make me feel the need to remind everyone of the forum guidelines:

 

Implying that someone does not prioritize their child's life is not respectful, kind or helpful. kgdg Please edit your post so that you may continue to post to this forum. 

I did not get that impression at all.  A large part of UC philosophy is trusting our bodies and our babies and accepting that we can not control life/death and they go hand in hand.  It has nothing to do with priorities.  I would rather not medically manage the possibility of death.  I feel that doing so would interrupt my physiologic process whether premature birth/miscarriage/conception or full term birth; I believe that managing that could put me in real physical and psychological danger.  So i completely understand what the OP was saying and don't feel that she should be bullied into editing it.   Okay, on second thought i checked out the posts of the poster in question and i can see where there could be an impression that this may not be a UC or even natural CB friendly individual.  


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#29 of 33 Old 10-07-2012, 10:58 AM
 
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It depends on how highly you prioritize knowing that your child is alive, and their condition at a given moment so you can take action to save them if they start losing oxygen.. If that information wont change your decisions, it is irrelevant.

I think this could be taken negatively depending upon individual choice.  Personally, I am un offended and in agreance with the general idea of it.  Which is about trust/surrender and personal empowerment with decision making.  The question I always ask myself is "What would i do with the information?"  


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#30 of 33 Old 10-07-2012, 11:12 AM
 
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As to the original question;  If you personally feel that electronic monitoring or any type of monitoring of anything in any way, will bring you more comfort than worry and you are comfortable with the new options and choices it may bring you... Then by all means do whatever it is you yourself need to do to be comfortable and assured.  Just be educated and open minded and self respecting about it.  That's what UCing is about for me.  It is a very personal process.


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