What is the need for electronic fetal heart monitoring during pregnancy, labor, and delivery? 

The progress of medical science and technology has made it possible for doctors to monitor every minute movement of pregnancy and labor in great detail. The entire journey of pregnancy is full of doctor’s appointments, regular check-ups, tests, and scans because they play a vital role in your journey. When your baby is peacefully floating in a warm amniotic sac, he/she can become stressed out by uterine contractions. To assess the healthy growth and development of your baby the doctor will use fetal heart monitoring to check on the rhythm and rate of the heartbeat of your baby. Fetal heart monitoring is a part of your regular check-ups during pregnancy and one of the reliable methods for your doctor to easily detect an abnormal heart rate. To safeguard the child and the mother the doctor might recommend you to undergo fetal heart monitoring if:

• You have diabetes.

• High blood pressure levels

• Taking medicines for preterm labor

• Your baby is not growing and developing the way he/she should.

The purpose of fetal monitoring is to ensure that the heart rate is normal and that gives a green signal to your doctor to proceed with the process of childbirth. There are 2 different methods of fetal monitoring:

• Intermittent auscultation

• Electronic fetal monitoring (EFM)

Intermittent auscultation is a method that is done with a help of a transducer. With the help of a transducer, the doctor can monitor your baby’s heartbeat at a set time throughout your labor. Electronic fetal monitoring is a method in which graphic and numeric information of the fetal heart rate (FHR) is recorded. EFM can be internal and external.

External EFM- Your ob-gyn may wrap a pair of belts around your abdomen. One belt uses Doppler to detect the heart rate of the fetus. The other belt measures the length of each contraction and the duration between them. These elastic belts have a flat device (sensors) in them and these sensors are connected to a machine that records every detail. You can hear the heartbeat of your baby and the doctor can take printouts of the recorded numeric and graphic information. How often you have contractions and for how long they lasted can be printed on a chart. EFM isn’t painful however it can be uncomfortable for a pregnant woman because of the transducers that are strapped to the belly during labor.

Internal Monitoring is done when your cervix has dilated to at least 2 centimeters. The monitoring is done during labor and when your amniotic sac has ruptured. Internal monitoring gives a more accurate record of FHR. During this monitoring, a sensor is strapped to your thigh and a tiny electrode (thin wire) is inserted into your cervix. When the tiny wire gets attached to the scalp of your baby when inserted into your uterus, you can listen to your baby’s heartbeat loud and clear with the help of a monitor.

If you have a low-risk with no complications then Intermittent auscultation is an acceptable method. Continuous EFM is required when you have developed complications during pregnancy or labor, you have a preexisting medical condition like hypertension, heart disease, and diabetes. It is also required if you have got an epidural or you require oxytocin to induce labor. If your baby’s heart rate is abnormal then your doctor might recommend you to undergo some more tests and scans before arriving at any decision. An abnormal heart rate doesn’t always indicate that there is something fishy, further tests will determine the actual issue.