Foetal Monitoring During Labour.

[blue daisy]

continuous fetal montinoring or CTG's has been introduced into 'standard' care in labor for a variety of reasons (inductions, epidurals. percieved risk)...but there is not any evidence based practise for this...CTG's increase medical intervention but do not increase health outcomes for mother and baby

intermittent monitoring remains the best way to check your baby during labor, most mw's will want to check this every 15 mins or so once you are in established labor

x

[krysalyss]

I had an induction and ended up with continuous monitoring. When I tried to get up bubs heart rate kept dropping. It was also a reaction to the induction drug causing tonic contractions (the drip had to be stopped completely but I went into natural labour). So I stayed on the bed and the monitor the whole time. I ended up in a few different positions but probably wouldnt have argued anyway. It was pretty scary having the heart rate alarm go off and lots of people pour into the room. But it wasn't a usual labour.

[Neenee Jellybeanie]

You have the legal right to refuse ANY intervention that you don't want!

[Ozziehoffy]

I hear where you're coming from, however, I'm so very grateful that they did want to check bubs heartrate cos it turns out it was dropping to 40 bpm after every contraction. The only internal I had was after they saw this happening continuously to check where he might be. He was still sitting up high. So we had some intervention, still had VBAC though but like I said, very grateful for the fact they did like to do a check. Just another view

[Toomanytoomany]

With delivery #5 (my fourth induction) I was told I would have to have continuous monitoring. I was a bit cross because this wasn't the case with my other inductions. My sister was with me and she suggested that we make sure we place the belts so that I could still move, and indeed this was possible, even though at times my sister had to lie across the bed and hold the transducers inthe right spot!

I'm glad in the end I had it on, because one very comfortable position (on the birth ball) led to some kind of issue for the baby and I had to move to get the heartbeat back to a favourable trace.

I'm generally not in favour of continuous monitoring, however.

[tutmae]

This may be a silly question, but may I ask the reasons for not having continual monitoring if it's suggested? I too am starting to look into birth plans and whatnot, but am very much a "if the doc/midwife suggests it I'll do it" type gal.

[alioops]

Tutmae, Often continuous monitoring requires laying flat on your back for the whole labour. Intermittent monitoring allows for more movement thus making things faster and more natural. Many continuous monitoring systems aren't waterproof which also restricts natural pain relief options. Unfortunately some middies and drs like to do things by the clock and like to over-medicallise births. Pregnancy is not an illness to be treated, it is a medical condition to be supported and allowed to progess naturally, unless there is something that is actually wrong. Intermittent monitoring does provide an accurate picture of what is happening because it is doen both during contractions and between them. HTH

[Tobily]

This may be a silly question, but may I ask the reasons for not having continual monitoring if it's suggested? I too am starting to look into birth plans and whatnot, but am very much a "if the doc/midwife suggests it I'll do it" type gal.

Aside from the extremely restrictive nature of constant monitoring, there is a good deal of evidence that use of it during a normal labour increases your risk of ending up with a caesarean. And the kicker is that it does not lead to more healthy babies.

Intermittent monitoring by hand held doppler has been shown over and over again to produce as good outcomes as continuous monitoring - without restricting the mother and without making her more likely to end up in theatre.

So why do they want us to use it? Because as kelly pointed out in another thread, it spits out a black and white record of everything that happened to the baby during that labour. A record that protects their backsides.

It's scary, but there are alot of practices used in obstetrics that aren't based on best evidence. And that aren't motivated by what's best for mum and baby. While we'd like to think that all hospital policy on this stuff is driven by good evidence, and by the needs of mum's and babies...hospitals are big institutions trying to deliver a service. So they're not just driven by you and your needs - they're driven by limiting liability, staffing issues, budgetary constraints - lots of other stuff that can end up impacting on you at a time when you're least likely to be able to negotiate around it or fend it off.