This blog is written by Aliza Carr from Bumpnbub.
It is important that your baby’s heart rate is monitored during labour and birth to ensure they are coping. Birth can be a stressful event for some babies, and health care professionals can detect early signs that baby may be in distress through monitoring their heart rate. With your consent, your baby’s heart rate will be monitored from the start of active labour until they are born. This can be done through several different options outlined below.
The method in which your midwife will monitor your baby in labour will depend on several factors:
- If your labour is spontaneous and commences on its own, or if you are induced and labour is commenced artificially
- If there are any risk factors for you or your baby that may indicate continuous monitoring in labour (examples given below)
- If your midwife is able to safely monitor baby with the desired method, or if your midwife/OB has any concerns
A doppler
A doppler is a small handheld ultrasound device that is used to listen to your baby’s heart rate intermittently throughout labour and birth. Your midwife will listen to baby’s heart rate for about 60 seconds every 15-30 minutes during labour, and more frequently during the pushing stage. The doppler is great for low-risk pregnancies, allowing you the freedom to move in labour and not have straps or a monitor on you. The doppler does only provide a snapshot of your baby’s heart rate for that minute, so if there are any concerns during labour another monitor may be used to further assess bubs’ heart rate and wellbeing.
Cardiotocograph (CTG)
The CTG provides continuous monitoring of your baby’s heart rate which is recorded onto paper or a computer. A CTG is left on all the time in labour if monitoring with a doppler is not appropriate, or it may be used for a shorter interval to check on baby and then continuing with doppler monitoring.
A CTG is used if there are concerns regarding baby’s wellbeing, you have any risk factors, or your labour has been artificially started. This is because health professionals can detect signs that your baby may be in distress earlier on a CTG compared to a doppler. Risk factors which indicate using a CTG include preterm labour (prior to 37 weeks), meconium liquor, bleeding, or a small or growth restricted baby. The other 2 reasons your midwife may apply the CTG are the use of the syntocinon infusion and/or an epidural. In these two cases a CTG is highly recommended even if you don’t have any other risk factors. At any point during your labour, if your midwife or OB are concerned about baby, it may be recommended to apply the CTG monitor to assess their wellbeing.
The only disadvantage with the CTG is that you are connected to the monitor at all times, which can be restrictive. Most facilities should have a wireless CTG that you can request if you want to move around the room, these should also be waterproof so you can get in the shower. Having a CTG may impact you being able to labour or give birth in bath, depending on your healthcare provider’s recommendation.
Fetal Scalp Electrode (FSE)
The FSE is often referred to as ‘the clip’, and is a tiny device applied directly to your baby’s head. Applying a FSE is done through a vaginal examination, where your cervix needs to be at least 2-3cm open, and it remains on your baby’s scalp until they are born.
The FSE is connected to the CTG machine, so it also provides continuous monitoring of your baby’s heart rate. An FSE is used if the CTG monitor is not picking up your baby’s heart rate effectively or if there are any concerns. Some mums request the FSE in labour instead of a CTG machine as it does provide freedom of movement and a direct way to monitor bubs wellbeing. It can leave a little mark or scab on your baby’s head when it is removed and there is a small chance of infection.
This blog is general advice only and does not replace the need for medical advice. For any questions or concerns, contact your healthcare provider.