During labour, your midwife monitors your baby’s heartbeat. This is so they can detect any sign of distress as early as possible. A normal heart rate is between 110 to 160 beats per minute.
Your healthcare team may use:
- intermittent monitoring - when you are monitored at different times during labour
- electronic fetal monitoring (EFM)- which monitors you and your baby continuously
- fetal blood sampling - where an obstetrician takes a small blood sample to check your baby's heart rate
Intermittent monitoring
Intermittent monitoring is when you are monitored at different times during labour.
For intermittent monitoring, your midwife may use a:
- fetal stethoscope - a trumpet-shaped stethoscope
- doptone or doppler - a small hand-held device
They will place the instrument on your tummy to listen to your baby's heartbeat.
Your midwife will listen to your baby's heartbeat every:
- 15 minutes during the 1st stage of labour
- 5 minutes during the 2nd stage of labour
They may start electronic monitoring if there are concerns about you or your baby.
Electronic fetal monitoring (EFM)
Electronic fetal monitoring (EFM) monitors you and your baby continuously.
Your midwife places electrodes on your tummy. The electrodes are connected to a large device. A screen or paper strip shows your contractions and your baby's heartbeat.
Your midwife may attach a clip with an electrode to your baby's scalp instead of on your tummy. This can measure your baby's heartbeat better. They will ask for your consent to do this.
You can still get out of bed during EFM. But you may not be able to move around much.
When EFM is used
EFM is commonly used during labour.
Your midwife will use EFM if your pregnancy is at 42 weeks or more, or if you request an epidural.
Other reasons EFM may be recommended are if:
- you have a fever or high blood pressure
- your baby's size or heartbeat is a concern
- labour is being induced, strengthened with oxytocin or lasting for more than 8 hours
- your waters are a low quantity, break over 24 hours before labour or stained with meconium (newborn poo) or blood
Fetal blood sampling
If there is more concern about your baby's heartbeat, your midwife may ask an obstetrician to review your baby's heart rate. The obstetrician may recommend fetal blood sampling.
They will ask for your consent to do this procedure.
During the procedure, you lie or tilt on your left side with your right leg raised.
Your obstetrician will:
- insert a speculum into your vagina
- make a tiny cut on the skin of your baby's scalp
- collect 1 or 2 drops of blood
The blood sample is tested for acid and oxygen levels which can show how well your baby is coping with labour.
If the result is normal, your labour can continue.
If the result shows your baby is distressed, your obstetrician may recommend immediate delivery of your baby.
