Some facts about foetal monitors in the UK:
Foetal monitors are devices that measure the heart rate and movements of the unborn baby during labour and delivery.
Foetal monitoring can help detect signs of distress or hypoxia (lack of oxygen) in the baby and guide appropriate interventions to prevent harm.
There are different methods of foetal monitoring, such as intermittent auscultation (listening to the baby’s heartbeat with a handheld device), cardiotocography (CTG, recording the baby’s heartbeat and contractions with electronic sensors), and fetal blood sampling (FBS, taking a small sample of blood from the baby’s scalp to measure the pH level).
The choice of foetal monitoring method depends on various factors, such as the woman’s preferences, the stage and progress of labour, the risk of complications, and the availability of equipment and staff.
In the UK, national guidelines recommend that low-risk women should have intermittent auscultation at least every 15 minutes in active labour, while high-risk women should have continuous CTG monitoring throughout labour.
Foetal monitoring can have benefits and drawbacks. For example, CTG monitoring can provide more information about the baby’s condition, but it can also restrict the woman’s mobility, increase the likelihood of interventions (such as caesarean section or instrumental delivery), and cause false alarms or misinterpretations.
Foetal monitoring requires skilled staff who can perform, interpret, and act on the results. There are standardised criteria and classifications for CTG traces to improve consistency and accuracy.
Foetal monitoring is not a perfect method and does not guarantee a healthy outcome for every baby. Some babies may still suffer from hypoxia or brain injury despite normal foetal monitoring results, while others may have abnormal results but no signs of harm.
Foetal monitoring is an important part of intrapartum care, but it should be used in conjunction with other assessments of the woman and the baby, such as vital signs, urine output, pain relief, fetal movements, and clinical judgement.
What are the pros and cons of foetal monitors in the UK?
Foetal monitors are devices that are used to listen to your baby’s heartbeat during pregnancy and labour. They can help to assess your baby’s well-being and how they are coping with labour. However, there are different types of foetal monitors and they have their own advantages and disadvantages. In this blog post, we will explore the pros and cons of foetal monitors in the UK, based on the latest evidence and guidelines.
Types of foetal monitors
There are two main types of foetal monitors: intermittent and continuous.
Intermittent foetal monitoring
Intermittent foetal monitoring is when your midwife listens to your baby’s heartbeat at regular intervals using a hand-held device. There are two kinds of hand-held devices: a Doppler or a Pinard stethoscope. A Doppler is a small device that uses sound waves to detect your baby’s heartbeat and amplify it so you can hear it. A Pinard stethoscope is a cone-shaped device that is placed on your belly and allows your midwife to listen to your baby’s heartbeat directly.
Intermittent foetal monitoring is recommended for low-risk pregnancies and labours, as it allows you to move around freely and does not interfere too much with your comfort. It also reduces the risk of unnecessary interventions, such as caesarean sections or instrumental births, that may be associated with continuous monitoring.
Some of the pros and cons of intermittent foetal monitoring are:
- Pros: It is non-invasive, flexible, portable, cheap, and easy to use. It allows you to have more control over your labour and birth. It respects your privacy and dignity. It can be used in different settings, such as at home, in a birth centre, or in a hospital. It can also be used underwater, if you choose to have a water birth.
- Cons: It may not detect some rare but serious problems with your baby’s heartbeat, such as cord compression or placental abruption. It may be difficult to hear your baby’s heartbeat if you have a high BMI, if your baby is in an awkward position, or if there is a lot of background noise. It may also be uncomfortable for you to keep still while your midwife listens to your baby’s heartbeat.
Continuous foetal monitoring
Continuous foetal monitoring is when your baby’s heartbeat is monitored constantly using an electronic device. There are two kinds of electronic devices: a cardiotocograph (CTG) or a wireless monitor. A CTG is a machine that uses two belts attached to your belly: one to measure your baby’s heartbeat and one to measure your contractions. A wireless monitor is a small device that sticks to your belly and sends signals to a monitor via Bluetooth or Wi-Fi.
Continuous foetal monitoring is recommended for high-risk pregnancies and labours, as it can provide more detailed information about your baby’s heartbeat and how they are responding to labour. It can also alert your midwife or doctor if there are any signs of distress or abnormality in your baby’s heartbeat.
Some of the pros and cons of continuous foetal monitoring are:
- Pros: It can detect some rare but serious problems with your baby’s heartbeat that may require urgent intervention. It can provide a continuous record of your baby’s heartbeat that can be reviewed later if needed. It can also reassure you and your caregivers that your baby is doing well.
- Cons: It can restrict your movement and mobility during labour, as you may need to stay close to the monitor or attached to wires. It can also interfere with your comfort and privacy. It can increase the risk of unnecessary interventions, such as caesarean sections or instrumental births, that may have negative effects on you and your baby. It can also cause anxiety or confusion if the monitor shows false alarms or unclear readings.
How to choose between foetal monitors
The choice of foetal monitor depends on several factors, such as:
- Your health and medical history
- Your baby’s health and position
- Your preferences and expectations
- Your place of birth
- The availability and quality of the devices
- The skills and experience of your caregivers
In general, intermittent foetal monitoring is suitable for most women with low-risk pregnancies and labours, while continuous foetal monitoring is advisable for women with high-risk pregnancies and labours. However, you should always discuss the pros and cons of each option with your midwife or doctor before making a decision. You should also be aware that you have the right to accept or decline any form of monitoring, and you can change your mind at any time during labour.
Summary
Foetal monitors are devices that are used to listen to your baby’s heartbeat during pregnancy and labour. They can help to assess your baby’s well-being and how they are coping with labour. However, there are different types of foetal monitors and they have their own advantages and disadvantages. Intermittent foetal monitoring is recommended for low-risk pregnancies and labours, as it allows you to move around freely and does not interfere too much with your comfort. Continuous foetal monitoring is recommended for high-risk pregnancies and labours, as it can provide more detailed information about your baby’s heartbeat and how they are responding to labour. The choice of foetal monitor depends on several factors, such as your health, your baby’s health, your preferences, your place of birth, and the availability and quality of the devices. You should always discuss the pros and cons of each option with your midwife or doctor before making a decision.
