What is Fetal Monitoring? What You Need to Know
“Why is fetal monitoring important?”
“Is it safe for my baby?”
Are these questions running through your head? If so, you’re not alone.
Fetal monitoring is one of those medical terms that is frequently used, but many expecting parents don’t fully understand what it entails or their options.
Understanding fetal monitoring can actually help you feel more confident and prepared for your birth experience.
Knowledge truly is empowering.
What Fetal Monitoring Really Means
Simply put, fetal monitoring is how your healthcare providers keep track of your baby’s well-being during labor and birth. Think of it as a way to check in on how your little one is handling the journey.
During labor, your medical team wants to see how your baby’s heart rate responds to contractions, movements, medical interventions, and the overall progress of labor. This information helps them identify any potential concerns and make informed decisions about your care.
According to the American College of Obstetricians and Gynecologists (ACOG), fetal monitoring is used in the majority of U.S. hospital births. It’s become a standard part of modern birth care.
The main goal is to make sure your baby is getting enough oxygen and tolerating labor well.
How Fetal Monitoring Works
There are a few different ways your healthcare team can monitor your baby during labor.
External Electronic Fetal Monitoring:
This involves two belts placed around your belly. One belt uses ultrasound technology to track your baby’s heartbeat, while the other monitors your contractions. It’s non-invasive and gives your team continuous information about how you and your baby are doing.
If you or your baby shift around, there are times when the belts need a quick adjustment. It can be a bit of an annoyance, but it helps your team keep a close eye on your baby’s well-being.
Internal Electronic Fetal Monitoring:
Sometimes, external monitoring isn’t giving clear readings, or there are specific concerns. In those cases, your provider might recommend internal monitoring. This can involve:
- Placing a small fetal scalp electrode (a small wire that is attached directly to your baby’s scalp) to track your baby’s heart rate accurately.
- An intrauterine pressure catheter (IUPC) to measure the strength and timing of your contractions
Internal monitoring is more invasive than external methods, but it provides precise, continuous information about both your baby and your labor.
Intermittent Monitoring with a Doppler:
This approach involves your nurse or midwife checking your baby’s heart rate at regular intervals using a handheld portable device called a doppler. It’s often used in birth centers, home births, or for low-risk hospital births.
What the Monitoring Tells Your Healthcare Team
Fetal monitoring provides several pieces of important information:
- Your baby’s baseline heart rate (typically between 110-160 beats per minute).
- Changes in heart rate that show how your baby is responding to contractions and labor.
- Accelerations in heart rate, which are usually a healthy sign that your baby is doing well.
- Decelerations, or drops in heart rate, which might indicate your baby needs extra attention.
- Your contraction patterns — how often they’re coming, how long they last, and how strong they are.
This information helps your healthcare team understand how your baby is tolerating labor and whether any interventions might be needed.
Types of Fetal Monitoring
Continuous Monitoring
With continuous monitoring, you’ll have those belts around your belly throughout most of your labor, providing ongoing information about your baby’s condition.
This approach is commonly used when:
- You have an epidural
- You’re being induced with Pitocin
- You have a high-risk pregnancy (such as gestational diabetes, high blood pressure, or twins)
- You’ve had a prior c-section and are trying to have a VBAC (vaginal birth after a cesarean)
The benefits include constant oversight and quick identification if your baby shows signs of distress. Many parents find reassurance in knowing their baby is being watched closely.
However, continuous monitoring usually means you’ll need to stay close to the monitoring equipment, which can limit your movement during labor.
Research has also shown that in low-risk births, continuous monitoring can increase the likelihood of interventions like C-sections, without necessarily improving long-term outcomes for babies.
Intermittent Monitoring
a) Intermittent Electronic Fetal Monitoring (EFM)
Some hospitals allow intermittent EFM, where the same belts used for continuous monitoring are placed on your belly for periodic checks instead of all the time. This provides accurate heart rate and contraction information, but still gives you breaks from being strapped in continuously.
b) Intermittent Hand-Held Doppler Monitoring
With this approach, your healthcare provider checks your baby’s heart rate at regular intervals. Perhaps every 15-30 minutes in early labor and every 5-15 minutes during active labor.
The benefits are significant: you’re free to move around, walk, shower, use a birth ball, and change positions as needed. Movement usually helps you cope better with labor.
The trade-off is that care providers get less continuous data, so they might not catch changes in your baby’s condition right away between checks. They typically don’t recommend this approach for high-risk pregnancies that need closer monitoring.
Check Your Hospital’s Policies
Here’s a tip many parents don’t realize: not every hospital offers both intermittent and continuous fetal monitoring. Some hospitals have policies that require continuous monitoring, even for low-risk pregnancies. That means if you were hoping to move around freely or use intermittent checks, your options may be limited once you arrive.
It’s worth asking your provider early on: “Does this hospital allow intermittent monitoring for low-risk births?” and “Do you offer hand-held monitoring with a doppler for low-risk births?” Knowing the answer can help you make realistic plans and feel more in control. If intermittent monitoring is important to you, you might explore other options like birth centers or home birth with a qualified midwife — places where intermittent monitoring is more commonly supported.
Understanding your hospital’s policies ahead of time empowers you to advocate for what matters to you and feel confident and prepared for your birth experience.
Current Recommendations — What the Experts Say
This might surprise you: it’s actually most recommended to use intermittent monitoring for low-risk pregnancies, unless complications arise during labor.
Care providers typically use continuous monitoring as the standard approach for high-risk pregnancies or when labor is induced with medications.
Whatever the case, this decision should involve you.
Your healthcare provider can help you understand which approach makes the most sense for your specific situation, and you can express your preferences while staying flexible for safety reasons.
Making an Informed Choice
Remember, fetal monitoring is a tool…
A helpful one, but not a guarantee. Like many medical interventions, it provides valuable information but isn’t perfect.
Understanding both continuous and intermittent monitoring options allows you to have informed conversations with your healthcare team and advocate for the approach that feels right for your birth.
Consider including your preferences in your birth plan, but also stay open to changes if your medical situation shifts during labor. Sometimes what feels right at 38 weeks pregnant needs adjusting once you’re actually in labor.
Your Birth, Your Voice
It’s completely okay to ask questions about fetal monitoring.
You might ask:
- Based on my pregnancy, do you recommend continuous or intermittent monitoring?
- If we start with intermittent monitoring, under what circumstances might we need to switch to continuous?
- What are my options for staying mobile if continuous monitoring is recommended?
Your questions and preferences matter. Your comfort and confidence matter.
At Buddha Belly Doulas, we believe that understanding medical interventions like fetal monitoring helps you feel more prepared and empowered during your birth experience.
When you know what to expect and understand your options, you can focus on the incredible work your body is doing.
We’re here to help you navigate these decisions and feel confident in your choices, whatever they may be.
You’ve got this.
Want to learn more about what to expect during labor and birth? Our childbirth classes cover everything from medical interventions to comfort strategies. We’re always here for you.
Also check out: Anatomy Scan Ultrasound – What to Expect
