The progress of science and its application in medicine has made it possible for doctors to monitor pregnancy and labour in great detail, and intervene when needed to safeguard the baby and the mother. Once such way of monitoring the baby during pregnancy, labour and childbirth is foetal monitoring.
During labour and delivery, your doctor will be monitoring the baby’s heartbeat to check on the tiny heart’s status and its response to your contractions. This monitoring may also be done before labour as a part of regular check-ups during the pregnancy or when you notice any change in the frequency of baby kicks. Foetal monitoring can detect an abnormal heart rate which may be useful in detecting any health problems your baby could be facing. It is a reliable method of checking the baby’s heartbeat and helps the doctor take corrective measures.
It is as critical for doctors to carry out foetal heart monitoring during labour as it is to monitor it through the entire pregnancy. This process helps the doctors keep track of the baby’s heart rate and times the duration of the contractions you are experiencing. It is an extremely reliable method for your doctor to know if your baby is doing well or facing any problems. The purpose of foetal monitoring during labour is to ensure that the foetal heart rate stays normal. This assures you and your doctor that the delivery can proceed normally if there are no other problems.
The primary aim of foetal monitoring is to identify if the baby could be hypoxic (deprived of adequate oxygen levels) so that other assessments of foetal well-being can be carried out. If the results are positive, the doctor could decide to deliver the baby by caesarean section or instrumental vaginal birth.
Foetal monitoring at home is also an option if the right kind of equipment can be made available. This is mostly done when the mother has been recommended to stay at home or to make minimum movements.
There are three different methods of monitoring the baby’s heartbeat, and these are carried out depending on the need of the hour. These intrapartum foetal monitoring methods are divided into internal and external monitoring, and they are as follows:
If you are an expectant mother, you must already have experienced this method during your prenatal visits to the doctor. In intermittent auscultation, during the first stage of labour, the nurse or doctor checks the heart rate every 15 to 30 minutes and then increases the frequency to every 5 minutes during the second stage. The doctor keeps a check on the baby’s heart rate in between your contractions, to gauge if it falls between 110 to 160 beats per minute. This also allows the doctor to get a sense of the baby’s tolerance to your contractions.
While both are external foetal monitoring processes, they differ in the frequency of monitoring done. Intermittent auscultation records the foetal heart rate at pre-decided intervals or periods, while, as the name suggests, continuous monitoring is done throughout the labour or delivery.
Intermittent auscultation uses a device known as a Doppler transducer to measure the heart rate, while the foetal heart tracing (heart rate) in continuous monitoring is reviewed by the doctor on a regular basis using transducers and monitors for the display of information and data.
Intermittent foetal monitoring is carried out for women who are considered to have low-risk pregnancies. When the doctor anticipates issues related to the delivery, he carries out continuous monitoring so that corrective action can be taken at the right time.
All Foetal Heart Rate patterns that do not fall in either the normal (Category I) or the abnormal (Category II) range are considered to be category two foetal heart tracing. These tracings are then classified as atypical. If your doctor comes across such a pattern, he may attempt to change your position to reduce the cord compression and enhance blood flow to the placenta.
Your doctor will evaluate your baby’s heart rate throughout labour and keep a watchful eye for any signals that indicate a problem. He will be monitoring the baby’s baseline heart rate to know if it’s normal and evaluate the changes if any.
In the event of your baby’s heart rate being abnormal, the doctor will advise a few more checks and tests before arriving at a decision. Remember, an abnormal heart rate does not always indicate that something is wrong with your baby, and the tests which follow will determine the actual issue.
If your baby moves, its heart rate will go up during that time, and this is normal. It mirrors the increase in your heart rate when you exercise. It is only the unchanged fast heartbeat that can be disconcerting for the doctor.
As a corrective measure, the doctor may take steps to change your position or provide additional oxygen to you. Giving you the necessary fluids through an intra-venous method can also give positive results. In case these measures do not yield the expected result, the doctor may decide to deliver the baby using the caesarean method or by applying forceps or vacuum to draw the baby out.
Foetal monitoring is an important way to monitor the health of the baby before birth. Some level of monitoring is performed on a regular basis, and even if the doctor recommends extra monitoring, it should not give you any cause for concern. Make sure you speak to your doctor if you are worried, and take his advice to ensure your baby’s safety.