Understanding fetal monitoring

by Kaiser Permanente |
Doctor doing CTG trace on a pregnant women in hospital.

It’s important to track your baby’s well-being during labor and birth. Different types of fetal monitoring are used to see how your baby is doing. The type of fetal monitoring that is recommended will depend on your personal medical and pregnancy history, any labor interventions being used, and how your baby is doing.

Below we discuss the types of monitoring and the benefits and the risk involved.

Types of fetal monitoring

With intermittent monitoring, a handheld device called a doppler is used to listen to the baby’s heartbeat at predetermined intervals based on your stage of labor. This is the same device that your clinician uses to listen to your baby during clinic visits.

Intermittent monitoring can be used during labor when there are no health issues and no labor interventions. The baby’s heartbeat might be checked every 30 minutes during active labor and every 5 minutes or so in the pushing phase.

With continuous external monitoring, monitors are attached to your belly. These check your baby’s heartbeat and your contractions consistently, without interruption. This type of monitoring is used when your care team needs to observe your baby more closely. It is necessary when you have high-risk conditions or are using labor interventions like an epidural. Wireless and waterproof external monitors mean you can move around and use a tub or shower.

Internal monitoring is only done in certain situations when consistent monitoring is needed. An electrode is placed on the baby’s head and provides information about its well-being. An intrauterine pressure catheter tracks your contractions.

Benefits of fetal monitoring

Intermittent monitoring can help reassure you that your baby is doing well. It tells your care team that your labor can go on at its own pace. You’re not attached to monitors all the time, so you can move about more freely. It can help reduce the use of labor interventions and can lower the chances of a Cesarean.

Continuous fetal monitoring lets your care team know about problems right away. That way they can take action to keep you both healthy and safe. It can tell you and your care team how strong your contractions are and how your labor is progressing.

Risks of fetal monitoring

Intermittent monitoring has few risks when there are no medical complications or risk factors.

Continuous monitoring can limit how much you are able to move during labor. It could show a change in your baby’s heartbeat when there isn’t one. This may lead to the use of birthing aids like vacuums or forceps. You could be more likely to have a Cesarean birth.

Internal monitoring can increase your risk of infection.

Choosing how to monitor your baby

Your care team will be tracking your baby’s well-being during your labor and birth. You can include your monitoring preferences in your childbirth preferences plan. Be sure to talk to your care team about it. Some labor choices, such as having an epidural, require a certain type of monitoring. Your clinician can help you decide which type of monitoring might be best for you.

This article has been created by a national group of Kaiser Permanente ob-gyns, certified nurse-midwives, pediatricians, lactation consultants and other specialists who came together to provide you with the best pregnancy, birth, postpartum, and newborn information.

Some of the content is used and adapted with permission of The Permanente Medical Group.