Continuous Electronic Fetal Monitoring
What to Know:
- Routine continuous EFM provides no benefit for babies and increases the risk of instrumental (e.g., use of forceps) vaginal deliveries and cesarean for mothers.
- The American College of Obstetricians and Gynecologists (ACOG) recommends that for healthy, low-risk women (almost all women), fetal heart rate be monitored with a fetoscope or Doppler every 30 minutes in active labor and every 15 minutes during pushing.
- The World Heath Organization (WHO) encourages intermittent manual listening and warns that EFM is often used inappropriately.
You May Need Continuous EFM if:
- Your labor is induced or speeded up with Pitocin.
- You have an epidural.
- Your baby’s heart rate changes.
- You or your baby has a health problem.
How to Avoid Unnecessary Use:
- Remember that routine use of continuous EFM doesn’t make labor safer for your baby.
- Find a caregiver who doesn’t use continuous EFM routinely.
- Talk to your caregiver about intermittent fetal monitoring.
- Stay at home as long as possible in labor.
How to Keep Labor as Normal as Possible If You Use Directed Pushing:
- Remember that your body knows how to protect your baby during labor.
- Continue to move as much as possible, both in and out of bed.
- Ask staff to turn off the monitor’s sound.
- Ask staff to turn the monitor away from you and your helpers so it doesn’t distract you.
- Ask for a telemetry monitor (that is, one that’s not attached by wires to the machine).
- Ask to be disconnected from the monitor for regular trips to the toilet.
- Remind your helpers that you are the one in labor, not the machine.
