Fetal Monitoring
So this is a quick and dirty little video all about monitoring! This is one of those terms and ideas that gets thrown around a lot in class a lot without being properly explained, I think, and I am guilty of this, so I wanted to take some time to go over the different kinds of monitoring.
So specifically, continuous and intermittent monitoring refers to fetal monitoring, which specifically is watching baby’s heart rate. The idea behind this is that baby’s heart rate is one of the only cues we have that everything is well with baby during labour so of course we like to keep an eye on them, but different care providers will do this in different ways.
If I can figure out how to edit videos and put photos in videos, on this side you’ll see what continuous monitoring looks like and on this side you’ll see intermittent monitoring. If for some reason I can’t figure it out, see down below for the first photo for continuous monitoring and the second for intermittent.
For most, if not all of you, one of these will look familiar. During your care provider meetings, they will listen to baby’s heart rate with one of these tools, mostly like the intermittent monitoring with the doppler. And if you’ve gone for an NST, non-stress test, then the the continuous monitoring will look familiar.
So during labour, your care provider will either be listening continuously or intermittently. Now, if you’ve already watched the BRAIN video, you will know that even if we know what we want, in this case the type of monitoring, I still think it’s important to go over the benefits, risks, alternatives for both types and listen to our intuition to really be able to make the best, most consensual and informed decision possible.
Continuous monitoring is routinely used in hospitals, specifically with folks who have OBs and family care practitioners as their caregivers. Continuous monitoring means that you are ‘tied’ to the monitor, with two tocos to monitor the babies and contractions, and if the machine is wired then two cords connecting each toco to the monitoring machine. If I have been able to do this correctly, this video will not cut to a clip of someone being on ‘continuous monitoring’ but if not please see video one down below. So you can see the two bands around their belly, you can hear the baby’s heartbeat in the background and it’s never not listening to baby. When I say it restricts movement, often the monitors will slip or fall off or not be able to ‘find’ baby so the birther is often restricted to standing up or lying flat on their back, which isn’t always what would be most helpful or most comfortable for the birther. And just for good measure, he’s my favourite Birthtuber playing with hers a little bit so you can see it from another angle.
So continuous monitoring is always on, whereas intermittent of course is, intermittent. In labour, this means we listen to the baby every 15 minutes with the doppler to make sure they’re a-okay, and this is the primary way of monitoring that midwives use with their clients. Here is a video of that.
You can see how the midwife listens to re-affirm baby’s well, and does so over and over again during labour. While someone labours, baby is listened to every 15 minutes and during pushing, they listen every 5 minutes or between pushes. Intermittent monitoring is great because the birther is actually free. Their contractions are not being constantly monitored, they can move in whichever which way their heart and body and baby desires and we as support people are free to focus on the birther, rather than the screen with data.
Intermittent monitoring is what midwives routinely offer and provide to folks in physiologically normal labour, whereas a hospital’s default is continuous monitoring. Even if the continuous monitoring is ‘wireless’, the tocos often still restrict movement because if the birther is in any kind of position or engaging in any coping technique that moves the tocos or causes them to not lay flat against the belly then they will be asked to stop doing that or get into another, often less comfortable and less helpful labour-wise position.
Down below there are going to be a few different resources for you – there is some interesting evidence about continuous monitoring vs. intermittent monitoring and outcomes, and I think it’s important to consider this information when discussing monitoring options with care providers. As I mentioned earlier, it is super important to have those BRAIN conversations with your care provider before labour, but the decision about what kind of monitoring is appropriate and best happens DURING labour. Down below I’ve created a PDF with some common happenings during labour, monitoring options, and some reflection questions. Please go through this at your speed, ask me any questions you may have and of course have good chats with your care team when it comes to your preferences just to make sure what is important to you aligns with their most common practices.
So this is a quick and dirty little video all about monitoring! This is one of those terms and ideas that gets thrown around a lot in class a lot without being properly explained, I think, and I am guilty of this, so I wanted to take some time to go over the different kinds of monitoring.
So specifically, continuous and intermittent monitoring refers to fetal monitoring, which specifically is watching baby’s heart rate. The idea behind this is that baby’s heart rate is one of the only cues we have that everything is well with baby during labour so of course we like to keep an eye on them, but different care providers will do this in different ways.
If I can figure out how to edit videos and put photos in videos, on this side you’ll see what continuous monitoring looks like and on this side you’ll see intermittent monitoring. If for some reason I can’t figure it out, see down below for the first photo for continuous monitoring and the second for intermittent.
For most, if not all of you, one of these will look familiar. During your care provider meetings, they will listen to baby’s heart rate with one of these tools, mostly like the intermittent monitoring with the doppler. And if you’ve gone for an NST, non-stress test, then the the continuous monitoring will look familiar.
So during labour, your care provider will either be listening continuously or intermittently. Now, if you’ve already watched the BRAIN video, you will know that even if we know what we want, in this case the type of monitoring, I still think it’s important to go over the benefits, risks, alternatives for both types and listen to our intuition to really be able to make the best, most consensual and informed decision possible.
Continuous monitoring is routinely used in hospitals, specifically with folks who have OBs and family care practitioners as their caregivers. Continuous monitoring means that you are ‘tied’ to the monitor, with two tocos to monitor the babies and contractions, and if the machine is wired then two cords connecting each toco to the monitoring machine. If I have been able to do this correctly, this video will not cut to a clip of someone being on ‘continuous monitoring’ but if not please see video one down below. So you can see the two bands around their belly, you can hear the baby’s heartbeat in the background and it’s never not listening to baby. When I say it restricts movement, often the monitors will slip or fall off or not be able to ‘find’ baby so the birther is often restricted to standing up or lying flat on their back, which isn’t always what would be most helpful or most comfortable for the birther. And just for good measure, he’s my favourite Birthtuber playing with hers a little bit so you can see it from another angle.
So continuous monitoring is always on, whereas intermittent of course is, intermittent. In labour, this means we listen to the baby every 15 minutes with the doppler to make sure they’re a-okay, and this is the primary way of monitoring that midwives use with their clients. Here is a video of that.
You can see how the midwife listens to re-affirm baby’s well, and does so over and over again during labour. While someone labours, baby is listened to every 15 minutes and during pushing, they listen every 5 minutes or between pushes. Intermittent monitoring is great because the birther is actually free. Their contractions are not being constantly monitored, they can move in whichever which way their heart and body and baby desires and we as support people are free to focus on the birther, rather than the screen with data.
Intermittent monitoring is what midwives routinely offer and provide to folks in physiologically normal labour, whereas a hospital’s default is continuous monitoring. Even if the continuous monitoring is ‘wireless’, the tocos often still restrict movement because if the birther is in any kind of position or engaging in any coping technique that moves the tocos or causes them to not lay flat against the belly then they will be asked to stop doing that or get into another, often less comfortable and less helpful labour-wise position.
Down below there are going to be a few different resources for you – there is some interesting evidence about continuous monitoring vs. intermittent monitoring and outcomes, and I think it’s important to consider this information when discussing monitoring options with care providers. As I mentioned earlier, it is super important to have those BRAIN conversations with your care provider before labour, but the decision about what kind of monitoring is appropriate and best happens DURING labour. Down below I’ve created a PDF with some common happenings during labour, monitoring options, and some reflection questions. Please go through this at your speed, ask me any questions you may have and of course have good chats with your care team when it comes to your preferences just to make sure what is important to you aligns with their most common practices.