Fetal Monitoring

Fetal monitoring is by and large done electronically in birthing facilities. Electronic Fetal Monitors are used to detect and trace the fetal heart rate and uterine contractions. These are usually monitored at the same time however, each one can be obtained separately. In terms of electronic fetal monitoring, it is either external or internal.

Fetal monitoring is a valuable tool for measuring fetal well being and assessing labor progress. Due to the sensitivity of the monitor, it may indicate a contraction is diminishing even before you notice the pain subsiding. This information can be a very useful energy saving tool and source of encouragement for you and your partner. Continuous electronic fetal monitoring does limit your mobility regarding walking around, however, if you are able, sitting up in a chair or on the side of the bed with your legs supported are options to staying confined to the bed.

• External Fetal Monitoring
• Internal Fetal Monitoring

External Fetal Monitoring

External fetal monitoring means that the baby's heartbeat is detected by placing a small round ultrasound (high-speed sound waves) disc with ultrasound gel on your abdomen and held in place by a lightweight stretchable band or belt. Uterine contractions are recorded from a pressure-sensitive device that is placed on your abdomen and also held by a lightweight stretchable band or belt. External monitoring of contractions in this manner only tells how often your contractions are occurring and how long each is lasting, but not their actual strength.

When you first arrive at the hospital or birthing center, part of the initial assessment of you and the baby is 20-30 minutes of externally monitoring your uterine contraction pattern and the baby's heart rate in response to them. Usually, if the initial fetal heart rate and contraction pattern show that both mom and baby are doing well, the monitor is removed and used intermittently. If there are no indications for continuous fetal monitoring, it is OK to ask the nurse to remove the monitor to allow you to walk. 

Internal Fetal Monitoring

If your physician, midwife or labor nurse(s) feel a need to observe the baby's heartbeat more closely, internal monitoring may be used. A smallelectrode is attached to the baby's scalp to directly monitor the baby's heartbeat. This is possible only after the bag of water has/or is broken. Internal fetal heart rate monitoring may be more comfortable since one of the pieces places around the mother's abdomen will be removed, which allows more freedom of movement.

Depending on your labor progress, it may also become necessary for your provider and labor nurse(s) to know the actual strength of your contractions. This is done internally by performing a vaginal exam and placing a thin, catheter-shaped monitoring device inside the uterus.

Internal fetal monitoring is a valuable tool for measuring fetal well-being and strength of contractions. Due to the sensitivity of the monitor, it may indicate a contraction is diminishing even before you notice the pain subsiding. This information can be seen on the fetal monitor graph paper and can be a very useful energy saving tool and source of encouragement for you and your partner. Continuous electronic fetal monitoring does limit your mobility regarding walking around. However, if you are able, sitting up in a chair or standing at the bedside are options to staying confined to lying in the bed.