Your midwife will monitor you and your baby throughout labour to make sure you are both well. Your midwife will listen to your baby's heartbeat. This will help the midwife with information about how your baby might be coping with the labour.
You'll be encouraged to move around as much as you want as this will help your labour to progress.
The midwife will listen to the baby's heart every 15 minutes during the first stage of labour and every 5 minutes during the second stage of labour. This will include using a small hand-held device to listen to your baby's heart, called a hand held doppler/sonicaid or pinard.
If there are any concerns regarding you or your baby your midwife may suggest continuous electronic monitoring, a cardiotocograph (CTG). This type of monitoring will also be advised if you choose to have an Epidural.
Continuous electronic monitoring can also be provided via a fetal scalp electrode (FSE). This is a small clip that can be attached to the baby’s head and provides a more direct heart rate recording from the baby.
Sonicaid/Hand Held Doppler or Pinard
If you have had a normal, healthy pregnancy with no problems so far, the midwife will advise that your baby’s heartbeat can be listened to using a sonicaid and or Pinard.
A sonicaid is a small, hand-held machine the midwife or doctor uses to listen to the baby during your pregnancy.
A Pinard is a non electronic listening trumpet.
A wooden pinard
Cardiotocograph (CTG)/Electronic Fetal Monitoring (EFM)
Sometimes Cardiotocograph (CTG) or electronic fetal monitoring (EFM) is used to monitor your baby's heartbeat continuously. The machine also records when you are having contractions. This means you'll need to wear two belts around your bump to hold the monitoring devices in place. You can continue to be in an upright position for this type of monitoring eg. sitting on a ball. Some of our machines are wireless which enable you to be more mobile or used in water, so please ask if they are available.
You can ask to be monitored electronically even if there are no concerns. You need to be aware that this can sometimes restrict how much you can move around.
Fetal Scalp Electrode (FSE)
You may be advised by your midwife or obstetric doctor to consider monitoring your baby's heart rate with a fetal scalp electrode. This is a small "clip" which can be placed on the baby's head during a vaginal examination.
It is very useful, if you and your baby's heart rate are similar (to tell the difference) or it is difficult to pick up your baby's heart rate via the abdominal monitor.
The FSE records the baby's heart rate directly from the baby, and can therefore be more accurate.
Applying a clip to your baby's head may allow you to be more mobile through labour. This device will not cause harm to your baby, but there will be a small mark on your baby's head - this usually disappears after a few days.
A clip will not be used if an infection is suspected.
What if my midwife is worried about my baby's heart rate?
If the electronic monitoring shows that your baby might not be coping with the effects of labour the midwife will ask for a review by the doctor (obstetrician).
Simple things can help like, changing position or having a wee.
If there are ongoing concerns the doctor may suggest taking a small blood sample from your baby's scalp to ensure that you baby is receiving enough oxygen during labour this is called a Fetal Blood sample (FBS).
This does not harm baby (although you may notice a small scratch on the baby's head following the birth), and gives an accurate and quick result to reassure that labour can continue. If this procedure is advised, you will be given further information.
If the FBS result does show that your baby is struggling with the labour or if the blood sample cannot be taken the doctor will advise a caesarean birth for your baby.
You and your partner/ birth support person will be fully informed at every stage of your labour and birth to support you to make informed decisions.