Fetal Monitor

What is a Fetal Monitor?

A fetal monitor is a machine that monitors your baby’s heart rate and your contractions. Your baby’s heart rate can be affected by the contractions, his/her movements, and interventions such as narcotics, an epidural, or an amniotomy (rupturing your membranes). Normal heart rate for a fetus is between 120-160 beats per minute. Monitoring your baby’s heart rate can help your care provider see potential problems before they become serious complications.

A fetal monitor is usually hooked up to a computer, allowing you to see your baby’s heart rate and your contractions on the screen. In most hospitals, the monitor is also hooked up to screens in the nurses’ station. Don’t worry! If your nurse isn’t in the room with you, she probably still knows what is going on with your baby’s heartbeat. In addition, there is usually a paper printout that runs constantly and can be put in your chart.

Depending on the hospital, your care provider, your nurse, and any interventions you may have, you may be monitored intermittently or continuously.

External Monitors

The external monitor is the one that is hooked up to the outside of your belly. Two flat panels are held in place by a belt or a girdle. One of these panels is actually an ultrasound device that sends and receives sound waves to detect fetal heart rate. The other is a pressure-sensitive device that measures your contractions. The external contraction monitor does not monitor the strength of your contractions, only how far apart they are and how long they last.

You do not have to be in bed while on the fetal monitor. You can be standing, slow dancing, sitting on a birthing ball, leaning over the bed, or sitting in a rocking chair. However, certain birthing positions can make it difficult for the monitor to pick up the baby’s heartbeat. If everything is going fine with your baby, your nurse or care provider may allow you to be off the monitor while you’re in a certain position. If you have to be on the monitor, ask your nurse to adjust the monitor until it can pick up the baby’s heart beat.

There are few risks to an external monitor. However, many women dislike being tethered to a machine or feel that their birthing team pays more attention to the machines than their needs. In addition, many women get annoyed if there is difficulty picking up the baby’s heart rate and the monitor has to constantly adjusted.

Internal Monitors

One choice your caregiver may decide on is an internal fetal monitor. An internal monitor is more accurate than an external monitor. It may be used if it seems like your baby is a little compromised, a problem may be developing, or there is difficulty picking up your baby's heart rate with an external monitor.

An internal monitor goes inside your vagina and is screwed into the skin of your baby’s head. It actually sounds worse than it is. As a demonstration, I have screwed internal monitors into the skin on my finger-—it doesn’t hurt and feels like sticking a straight pin into my skin.

An internal monitor is a little riskier than an external monitor. There is a risk of infection or skin lesions in the place where the monitor is applied. In addition, your membranes must be ruptured to place the monitor. If your membranes are ruptured, most care providers require you to deliver within 12-36 hours.

Your contractions can be monitored internally by placing an intrauterine pressure catheter (IUPC). During contractions, the increase in intrauterine pressure is measured. Now, you can see the strength of your contractions on the computer. This device is not screwed into your baby’s head, but placed along side him/her.

The majority of hospitals will allow you out of bed with an internal monitor in place, as long as you are careful not to pull it out. You can still be rocking in a chair, slow dancing, or sitting on a birthing ball with an internal monitor in place.