How External Fetal Monitoring has Tripled our C-Section rate

May 13, 2011

My couples always want to know what is so “bad” about external fetal monitoring in the hospital. It isn’t “bad”, but it does present several risks to the mother planning an unmedicated, vaginal birth. Here are some exerpts from an article about fetal monitoring, from www.birthsense.com. She describes the different types of monitoring and gives the benefits and drawbacks of each.

  1. [External Fetal Monitoring] inhibits movement in labor. Being able to move freely in labor is thought to help labor progress. Upright positions are more beneficial for making sure baby gets enough oxygen, and usually more comfortable for the mother.
  2. It has tripled the c-section rate, while the rate of deaths of babies during labor has not decreased. Fetal monitoring was invented in the hopes of detecting babies who were in distress during labor, but it has been unable to keep its promise. We’re diagnosing fetal distress three times as often as before we had continual monitoring, but most of the babies who are diagnosed with distress are actually just fine.
  3. It is very difficult to interpret. Fetal monitor strips are notoriously easy to misread, and providers and nurses frequently cannot agree on the meaning of what they see. This is part of the reason that c-section rates have increased. Providers are unsure if the baby is in distress or not, so they decide to do a c-section just in case.
  4. You are just as likely to take home a healthy baby with intermittent auscultation as with continual monitoring, and less likely to need surgery, emergency interventions, or drugs for pain.

So before you go [to the hospital], you need to know:

  • If you get onto the fetal monitor, there is a good chance you will never get off.
  • If you get onto the fetal monitor, you have a three times higher chance of a surgical delivery.
  • If you get onto the fetal monitor, you will be more likely to need pain medications during labor, which in turn can contribute to fetal distress.
  • You have the right to decline ALL fetal monitoring, even the admission strip.  A simple “No, thank you” is all you need to say.
  • You have the right to request intermittent auscultation.  If the results of the intermittent auscultation indicate that more intensive monitoring is needed, you still do not have to have continual fetal monitors applied to your belly.  You can request the nurse hand-hold the transducer to listen as frequently as needed, allowing you to continue to have freedom of movement.
Read the full article (it’s very informative) here.

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