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Fetal monitoring: What is it?

Fetal monitoring, in simpler terms, is nothing but monitoring childbirth or pregnancy. It includes regular tests done as a part of prenatal care. During labour, the healthcare practitioner or nurse checks the baby’s heart rate to keep tabs on how your little one is doing. This monitoring also enables your doctor to figure out if your baby is able to handle the pressure of your contractions (during labour).

Fetal monitoring is usually done with the help of an electronic fetal monitor or a handheld Doppler device, the same way your caregiver might have listened to your baby during your prenatal visits. Your baby's heart rate can be checked continuously with an electronic fetal monitor or periodically (this is called intermittent auscultation). Most women are hooked to an electronic fetal monitor more or less continuously throughout labour.

What is continuous fetal monitoring?

Wide, stretchy bands hold two electronic disks called transducers against your abdomen. One monitors your baby's heartbeat and the other tracks your contractions.

The transducers are connected to a machine across the mother’s bed, where it draws a graph on the attached paper. You can hear the galloping sound of your baby’s heart if the monitor is turned on. If you want to know exactly what the machine does and how it functions, you can ask your medical practitioner about the same.

Electronic monitoring isn’t painful. That being said, it can be uncomfortable for mothers at times, considering the fact that the transducers are strapped to their bellies. This restricts their movement and may make it hard to cope with contractions for some mothers.

Sometimes external monitoring is done remotely. This is called telemetry. It allows you to be checked without being hooked up to a machine. At some hospitals, the sensors can send the details about your baby's heart rate and your contractions to a remote monitor. This monitor is usually at a nurse's station. Using a remote monitor allows you to walk around freely.

How is intermittent auscultation done?

Your medical practitioner or labour nurse will hold up the Doppler or fetoscope against your belly and listen to your baby's heartbeat, just as he/she did during prenatal visits. They might also access the heartbeats of your baby by simply laying their hands on your belly.

Your nurse will check this at specific intervals, such as 15 to 35 minutes in the active phase of the first stage of labour. After this, the heartbeat will be checked after every five minutes during the second or the pushing stage. Doctors will also determine the ‘baseline’ heart rate (normally between 110 and 160 beats per minute) by counting your baby’s heart rate when he or she is not moving. In addition to the planned interval checks, your baby's heart rate will be evaluated as needed, such as before and after vaginal exams or when your water breaks.

So, to conclude, fetal monitoring is examining and making sure that both, mother and baby are safe during and before delivery. It enables doctors to make quick decisions and is a relatively simple process.

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