Ways that Your Baby’s Heart Rate can be Monitored during Labor
Whether you plan to give birth in a hospital setting or have a homebirth, your care provider will be checking your baby’s heart rate with some type of monitor to assess their well-being. Learning more about the options you may have as you choose your care provider as well as your place of birth is very important as you plan your birth. Here are some answers to questions you may have regarding fetal monitoring:
What is a normal heart rate for a baby during labor?
A baby’s heart rate typically falls between 120-160 beats per minute. There are many normal variations and fluctuations that can occur during the course of labor where your baby’s heart beat can climb a bit higher than that or even dip lower and it may still be normal. Obstetricians, nurse-midwives and labor and delivery nurses are all trained in reading and interpreting these normal variations during labor.
What types of monitoring is available in a homebirth?
Homebirth midwives will typically be listening to your baby’s heart rate with a doptone (the small instrument used for your prenatal visits) that uses ultrasound to detect the sound of your baby’s heart rate. Your midwife will be checking the baby’s heart rate frequently, both during and after contractions, to see how well your baby is managing contractions and tolerating labor.
What is used to monitor my baby in a birth center?
In free-standing birth centers where midwives are the primary providers, doptone are also used to check the baby’s heart rate. Again, it will be important for your midwife to be listening to your baby both during and after contractions and will need to do this frequently during labor. In some cases, waterproof devices can be used if you are laboring in the tub. Or another option for combining fetal monitoring with hydrotherapy is to put a sterile glove over the doptone so the tip does not come into contact with the water.
If I give birth in a hospital, what options for monitoring do I have?
Hospitals births typically require the use of electronic fetal monitoring. Ultrasound is still used to detect the baby’s heart rate, however the ultrasound device is held in place over your lower abdomen by a stretchy and very snug belt. In addition, a second device, called a toco transducer, is placed over the top of your abdomen (or the fundus of your uterus) which is a pressure-sensitive gauge to measure duration and frequency of contractions. This toco transducer is not an accurate measure of the strength of contractions and only the mother will be able to tell her birth team about how strong her contractions truly are.
Both of these devices are attached by cables to a display unit that gives a graph print out, an audible signal as well as a constant visual signal of the heart rate as well as contractions.
Some care providers prefer that the laboring mother wear these two devices continuously in labor. However the American College of Obstretricians and Gynecologists has stated that low risk mothers may have the option of intermittent fetal monitoring. This allows the laboring mother to be free and mobile for about 20-30 minutes of each hour.
Can I be monitored but still be free to move about during labor?
There is another type of monitor called a telemetry, in which the laboring mother wears the same devices but instead of being attached via cables to the display unit, the ultrasound and toco transducer are attached to a radio-controlled device that the mother carries. She may be able to walk out of her room and around the labor and delivery floor while still having her baby’s heart rate monitored. Not all hospitals have this portable monitoring device, so please ask your own hospital if this option is available.
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