by Andrea Stainbrook
We all have visions of what being in labor and what being in the labor room will look like. We try to envision ourselves coping, and breathing. But what about the extra things that we may need. What does that even look like? One thing all people will need at the very least intermittently is monitoring. Some will need to be monitored continuously throughout the entire labor process.
Let’s dive into what continuous monitoring looks like in an average hospital setting!
Firstly why would you need continuous monitoring? Every care provider will proceed to their comfort level on how they feel they can best determine if you and baby are doing well. EFM or Electronic Fetal Monitoring, will help your doctor/midwife determine if baby is tolerating a contraction well. Here are some instances that are common to be monitored throughout the entire birth process:
- The pregnancy is deemed high risk for any reason
- When you arrive to the hospital and they do an initial assessment where something seen requires it (it could be a heartbeat tracing the care provider isn’t fond of, high blood pressure, to name a couple)
- A medical intervention is being used or medical pain relief being administered
So you are told you need to be continuously monitored. What is the monitor and how does it work?
In the hospital room next to the bed there is always a little table or shelf. On that shelf sits the unit for the monitor.
There are wires that connect two separate pieces with belts to the monitor. One belt uses Doppler or ultrasound to measure the baby’s heart rate. The other is measuring the length and strength of the uterine contractions. The monitor unit will have a small screen and a printer that displays these tracings.
Monitoring was developed and is used to ensure that baby is doing well throughout the labor. Doctors and midwives use it as a tool to assess what is going on. With constant monitoring there are chances that care providers could change a course of care due to something they deem “non-reassuring.” It is always a good idea to discuss with your doctor or midwife how they like to proceed with monitoring and never feel you cannot ask questions.
Are there alternatives? Yes! Intermittent monitoring is most common for low risk pregnancies. That means the laboring person would be connected to the EFM as described above for a short period every hour or so just to see how baby is handling the contractions. Once everything is deemed OK you are disconnected. You can always ask if this is an option, or at what point it could become an option if you were told continuous monitoring is preferred. There are also wireless monitors or telemetry monitors that allow the sensors to be secured to the belly without any wires connecting you to a machine! Some can even get wet and allow continuous monitoring even in the water! Every hospital will be equipped with different kinds and amounts of these so ask at your hospital tour, your next appointment, or even when you arrive on the big day if these are available.
So physically is it a bummer to be monitored? Some would say for mobility reasons it is a downside. If you have to be connected to the beside monitor the wires still let you move around but you are limited. You will have space near the bed and on the bed. Don’t fret though! You can still get into lots of positions and allow yourself movement. Also they are not a perfect fit. As baby/babies move and as you move the best spots to pick up the readings may move too. So one common talked about downside is sometimes there is a need to readjust where they are placed often. So your nurse will keep readjusting the monitor throughout the labor. For some the bands themselves may be uncomfortable. Don’t hesitate to ask for help adjusting the bands to a more comfy position.
Monitoring throughout labor is a reality for some. Now you have an idea of what that may actually look like!