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Birth Wishes: STEP THREE: Monitoring
Step One:
http://www.medhelp.org/posts/GroupTrack-We-Want-a-Natural-Birth/Birth-Wishes-STEP-ONE-The-Opening/show/1475184
Step Two:
http://www.medhelp.org/posts/GroupTrack-We-Want-a-Natural-Birth/Birth-Wishes-STEP-TWO-Labor-Options/show/1476757
Welcome to the Birth Wishes series where we are working together to write our birth plans. In this step I'll be mentioning some things you may want to consider for monitoring during your labor. Because the main goal of this group is to have a natural birth those things will be emphasized but I will talk about other options you may want to consider in the event of induction or cesarean.
There are a few ways you are monitored while in labor. There is the monitoring of the baby's heart, your contractions, your heartbeat and your blood pressure. If you don't have Birth Wishes the default birth care you will most likely receive in a hospital would be to have two big black bands around your contracting belly, confining you to the bed in order to measure baby's heartbeat and your contractions. You will also have a heart-rate monitor on your fingertip, an automatic blood pressure cuff on your arm that is set to go off continually.
Sounds like a little much, doesn't it? Especially if a woman has no precursors for problems and baby is looking just fine. Some things may be necessity if you have a heart condition or struggled with your blood pressure; always discuss this with your doctor and do what feels best and safest for you.
Let's talk first about Fetal Monitoring. The monitoring of the baby's heart rate that I mentioned above is done continually and restricts your movements. If in STEP TWO of our series you decided you wanted the freedom to move you'll have to carefully consider how you want baby to be monitored during labor. There are a few ways:
-External Fetal Monitoring (which uses the band around your belly)
-Internal Fetal Monitoring (they screw it onto your baby's scalp; YES you read that correctly)
-Intermittent Fetal Monitoring (using a doppler every now and then; just like the one used at the doc's office)
External Fetal Monitoring (EFM) was introduced to monitor babies while in labor continually in an effort to decrease the increasing cesarean rate. What actually happened was the EFM did the opposite of its intention. It is not believed to not be necessity for the average, low-risk woman in labor anymore. However doctors still use this as the standard.
Internal Fetal Monitoring (IFM) just makes me cringe. Many doctors still believe to this day that newborns do not feel pain. Tell that to the screaming baby getting their Vitamin K injection across the room because it hurts. Anyway this article explains it in great detail:
http://pregnancy.about.com/od/fetalmonitoring/f/internalmonitor.htm
Intermittent Fetal Monitoring (doppler) is the one preferred by natural birthers. This allows mom the freedom to move as she wishes, it keeps those tight bands off of her sore, tender, contracting belly and she still has the security of checking on baby to make sure all is well. Midwives tend to use this method as their standard.
I had the doppler with my natural birth. I honestly hardly remember them checking on the baby. They'd just quietly come over, put the doppler on my belly, listen for several minutes and then leave me to continue laboring. Intermittent Fetal Monitoring may be more difficult with an OB-directed birth as the nurses and attendants may be too busy to come in and check on baby's heart consistently. This is another reason why hospitals prefer the EFM.
I wrote on my Birth Wishes:
"I understand the hospital requires 20 minutes of EFM when I arrive in labor. I'm happy to give you those 20-30 minutes and then I'd prefer the freedom to move around and to check on baby intermittently with a doppler."
Almost every hospital is going to require you give them some monitoring when you arrive. They need that strip of paper with your contractions and baby's heart rhythm for their records. I had no problem giving it to them whatsoever. It kept my midwife out of trouble, kept me as a compliant patient (who nurses LOVE) and then I was free to not be bothered anymore. If you find this to be a problem a birth center or home birth may be an option to consider or you may have a fight on your hands.
Measuring Contractions - it kind of makes me giggle that they want to put a band around your belly to measure contractions. While some women do not feel contractions, at least ones in early labor, there comes a point when they are very noticeable. The truth is that they measure your contractions from a big screen TV at the nurses' station so they can watch everyone's contractions together instead of spending time with you in your room. This is definitely one I refuse (except for the 20 or so minutes they require upon arrival to "prove" I'm in labor). I know when a contraction is coming and don't need a monitor telling me. I remember during my second birth I began vomiting at one point and the doctor rushes in with a big grin and says, "I saw huge spikes on the monitor, are you pushing?!" She was sitting there watching the big screen instead of staying with me in my room, supporting me during labor. It just didn't make sense. (She had no other patients; she came in on her day off because I asked her to.)
Mom's Heart Monitor - as mentioned above you may have a fun little clip on your finger measuring your heart-rate the entirety of your labor unless you mention on your birth plan that you'd prefer intermittent monitoring. This wasn't nearly as bothersome to me as the belly bands or IV (as I had them in my first two epidural births). However if you're wanting to move about they're going to have to compromise with you and allow intermittent monitoring so long as all is well with your heart health.
Blood Pressure Cuff - if you have a history of high blood pressure or are having problems with your blood pressure this may be something your doctor insists upon. As always you can refuse. But if you know you have a history of problems the wisest thing to do is allow the cuff to be worn. Otherwise ask for intermittent monitoring.
If you are being induced and have medication (such as Pitocin) the hospital requires continual monitoring. This will most likely mean you'll have the belly bands and need to be in bed, unmoving, so the readings are accurate.
Can you think of other ways they monitor you while in labor?
http://www.medhelp.org/posts/GroupTrack-We-Want-a-Natural-Birth/Birth-Wishes-STEP-ONE-The-Opening/show/1475184
Step Two:
http://www.medhelp.org/posts/GroupTrack-We-Want-a-Natural-Birth/Birth-Wishes-STEP-TWO-Labor-Options/show/1476757
Welcome to the Birth Wishes series where we are working together to write our birth plans. In this step I'll be mentioning some things you may want to consider for monitoring during your labor. Because the main goal of this group is to have a natural birth those things will be emphasized but I will talk about other options you may want to consider in the event of induction or cesarean.
There are a few ways you are monitored while in labor. There is the monitoring of the baby's heart, your contractions, your heartbeat and your blood pressure. If you don't have Birth Wishes the default birth care you will most likely receive in a hospital would be to have two big black bands around your contracting belly, confining you to the bed in order to measure baby's heartbeat and your contractions. You will also have a heart-rate monitor on your fingertip, an automatic blood pressure cuff on your arm that is set to go off continually.
Sounds like a little much, doesn't it? Especially if a woman has no precursors for problems and baby is looking just fine. Some things may be necessity if you have a heart condition or struggled with your blood pressure; always discuss this with your doctor and do what feels best and safest for you.
Let's talk first about Fetal Monitoring. The monitoring of the baby's heart rate that I mentioned above is done continually and restricts your movements. If in STEP TWO of our series you decided you wanted the freedom to move you'll have to carefully consider how you want baby to be monitored during labor. There are a few ways:
-External Fetal Monitoring (which uses the band around your belly)
-Internal Fetal Monitoring (they screw it onto your baby's scalp; YES you read that correctly)
-Intermittent Fetal Monitoring (using a doppler every now and then; just like the one used at the doc's office)
External Fetal Monitoring (EFM) was introduced to monitor babies while in labor continually in an effort to decrease the increasing cesarean rate. What actually happened was the EFM did the opposite of its intention. It is not believed to not be necessity for the average, low-risk woman in labor anymore. However doctors still use this as the standard.
Internal Fetal Monitoring (IFM) just makes me cringe. Many doctors still believe to this day that newborns do not feel pain. Tell that to the screaming baby getting their Vitamin K injection across the room because it hurts. Anyway this article explains it in great detail:
http://pregnancy.about.com/od/fetalmonitoring/f/internalmonitor.htm
Intermittent Fetal Monitoring (doppler) is the one preferred by natural birthers. This allows mom the freedom to move as she wishes, it keeps those tight bands off of her sore, tender, contracting belly and she still has the security of checking on baby to make sure all is well. Midwives tend to use this method as their standard.
I had the doppler with my natural birth. I honestly hardly remember them checking on the baby. They'd just quietly come over, put the doppler on my belly, listen for several minutes and then leave me to continue laboring. Intermittent Fetal Monitoring may be more difficult with an OB-directed birth as the nurses and attendants may be too busy to come in and check on baby's heart consistently. This is another reason why hospitals prefer the EFM.
I wrote on my Birth Wishes:
"I understand the hospital requires 20 minutes of EFM when I arrive in labor. I'm happy to give you those 20-30 minutes and then I'd prefer the freedom to move around and to check on baby intermittently with a doppler."
Almost every hospital is going to require you give them some monitoring when you arrive. They need that strip of paper with your contractions and baby's heart rhythm for their records. I had no problem giving it to them whatsoever. It kept my midwife out of trouble, kept me as a compliant patient (who nurses LOVE) and then I was free to not be bothered anymore. If you find this to be a problem a birth center or home birth may be an option to consider or you may have a fight on your hands.
Measuring Contractions - it kind of makes me giggle that they want to put a band around your belly to measure contractions. While some women do not feel contractions, at least ones in early labor, there comes a point when they are very noticeable. The truth is that they measure your contractions from a big screen TV at the nurses' station so they can watch everyone's contractions together instead of spending time with you in your room. This is definitely one I refuse (except for the 20 or so minutes they require upon arrival to "prove" I'm in labor). I know when a contraction is coming and don't need a monitor telling me. I remember during my second birth I began vomiting at one point and the doctor rushes in with a big grin and says, "I saw huge spikes on the monitor, are you pushing?!" She was sitting there watching the big screen instead of staying with me in my room, supporting me during labor. It just didn't make sense. (She had no other patients; she came in on her day off because I asked her to.)
Mom's Heart Monitor - as mentioned above you may have a fun little clip on your finger measuring your heart-rate the entirety of your labor unless you mention on your birth plan that you'd prefer intermittent monitoring. This wasn't nearly as bothersome to me as the belly bands or IV (as I had them in my first two epidural births). However if you're wanting to move about they're going to have to compromise with you and allow intermittent monitoring so long as all is well with your heart health.
Blood Pressure Cuff - if you have a history of high blood pressure or are having problems with your blood pressure this may be something your doctor insists upon. As always you can refuse. But if you know you have a history of problems the wisest thing to do is allow the cuff to be worn. Otherwise ask for intermittent monitoring.
If you are being induced and have medication (such as Pitocin) the hospital requires continual monitoring. This will most likely mean you'll have the belly bands and need to be in bed, unmoving, so the readings are accurate.
Can you think of other ways they monitor you while in labor?
You pretty much summed it up!!
The beauty of midwives is the fact that they stay with you for most of the labor process. I would get my blood pressure checked and the baby's heart rate every so often. I don't have a history of high blood pressure, in fact, when I am pregnant, my blood pressure is at it's best! Strange.
Last time, my midwife just sat with me and I told her when I would have a contraction or she would feel my belly for them, time a few and see how close they were and how long they would last. That would give her a better indication of how things were moving along.
The beauty of midwives is the fact that they stay with you for most of the labor process. I would get my blood pressure checked and the baby's heart rate every so often. I don't have a history of high blood pressure, in fact, when I am pregnant, my blood pressure is at it's best! Strange.
Last time, my midwife just sat with me and I told her when I would have a contraction or she would feel my belly for them, time a few and see how close they were and how long they would last. That would give her a better indication of how things were moving along.
Nope you said it all! I had a nurse come and check my BP every hour or so, and my heartrate i dont recall wearing the blinker. My DD was being monitored thruout all of labor. And my contrax were being monitored as well.
Hopefully My contrax wont have to be monitored, What for??? I do see a valid point with the little one being monitored but not my contractions.
Hopefully My contrax wont have to be monitored, What for??? I do see a valid point with the little one being monitored but not my contractions.
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