Patient education: Fetal monitoring during labor (The Basics)

What is fetal monitoring during labor? — This is a way to check how your baby is doing while you are in labor. Labor is when your body prepares to give birth.

The main things that are monitored during a normal labor are:

●The baby's heartbeat – This is also called "fetal heart rate monitoring." When you have a contraction, your uterus squeezes around the baby. Most of the time, the baby can handle this well. But if there is a problem, like the baby is not getting enough oxygen through the umbilical cord, this can cause changes in their heartbeat. Monitoring lets your doctor or midwife know if this might be happening.

●Your contractions – This includes measuring how often contractions happen and how strong they are. If contractions are not frequent or strong enough, labor can slow or "stall."

Why do I need monitoring during labor?

●Monitoring the baby's heart rate shows how the baby is doing.

●If labor stops progressing normally, monitoring contractions might show why.

What happens during monitoring? — This depends on your pregnancy and where you are giving birth.

Types of monitoring include:

●Electronic monitoring – This is the most common type in US hospitals. An electronic monitor prints information about the baby's heart rate and your contractions on paper. This lets the doctor or midwife see changes over time. Electronic monitoring can use information from "external" or "internal" devices:

•External – You will have special belts placed around your belly. One uses something called "Doppler ultrasound" to detect the baby's heartbeat. The other measures your contractions. You might need to stay in bed during external monitoring, but some hospitals and centers have wireless tools that let you move around.

•Internal – This type of monitoring can only be done after your water has broken. The doctor or midwife places a small "electrode" onto the baby's scalp. This is put in through your vagina and connected to a wire. The electrode measures the baby's heartbeat.

The doctor or midwife might also place a thin tube called a "catheter." This is inserted through your vagina and into your uterus. It can be used to measure your contractions.

●Listening to the baby's heartbeat – The doctor or midwife can also check the heartbeat by listening to it every so often. It can be done using a Doppler monitor, the same way that they checked your baby's heartbeat throughout your pregnancy. In some cases, they will use a special stethoscope instead.

What happens if monitoring shows a change? — If there is a change in your baby's heart rate, this does not always mean that there is a problem. It is normal for the heartbeat to speed up and slow down a little at times during labor. Your doctor or midwife will pay close attention to any changes to learn more.

If your doctor or midwife is concerned about your baby's heart rate, they might:

●Have you change positions

●Give you fluid through an IV (a thin tube that goes into a vein)

●Give you medicines to relax your uterus

●Have you change how often you are pushing

●Put a finger into your vagina to rub your baby's scalp, then see if their heart rate changes

If your labor is not moving along normally, you might get medicines to help increase contractions. If this does not work, or if there are concerns about your baby's health, you might need to have surgery to get the baby out. This is called cesarean birth or "c-section."

More on this topic

Patient education: Labor and childbirth (The Basics)
Patient education: Managing pain during labor and childbirth (The Basics)
Patient education: Cesarean birth (The Basics)

Patient education: C-section (cesarean delivery) (Beyond the Basics)