Electronic Fetal Monitoring
The electronic fetal monitor (EFM)
tracks the baby's heartbeat and records
the pressure of the uterus during
labour contractions. Introduced in the
1970's, EFM was first used only for
high risk pregnancies. Before proper
studies were completed, EFM became
routine in most Canadian and American
hospitals. Eighty percent of women
having babies are now hooked up to an
EFM.
What Is EFM
The external EFM consists of two straps
which go around your abdomen. One strap
holds a pressure gauge to record
contractions, and the other strap an
ultrasound transmitter to detect the
baby's heartbeat. This information
provides a continuous printed record of
heartbeat and contractions.
With the internal fetal monitor, an
electrode is inserted into the baby's
scalp and linked to a recording device
by a wire inserted though the mother's
vagina.
The baby's heart rate usually speeds up
during contractions. A heart rate which
slows down during or after contractions
may mean that the baby is having some
difficulty.
Is It Useful?
- Recent research has shown that EFM
during labour does not improve the
outcome for the baby.
- Intermittent heart beat checks by a
nurse or midwife using a hand held
stethoscope are as effective as EFM.
- This was true for high risk as well as
low risk women.
- Routine use of EFM increases the
C-section rate.
Other Disadvantages
- Mother confined to bed during labour.
- Annoying beeping alarm if mom changes
position.
- EFM machines frequently break down and
malfunction.
- Wide variation in EFM interpretation
from one doctor or nurse to another.
- False alarms can only be sorted out
through taking a sample of blood from
the baby's scalp veins to measure the
oxygen level and PH, which is traumatic
for the baby.
- Can take the place of regular checking
by the caregiver.
Other Options
- Find out whether your doctor uses EFM
routinely.
- If you have no major risk factors,
request your baby be monitored without
EFM.
- Doppler stethoscopes may improve
reliability of fetal monitoring during
labour compared to the ordinary fetal
stethoscope.
- Soothing presence, touch, words of
caregiver or labour coach (doula)
decrease complications.
