What to Expect When It Comes to Fetal Monitoring in Labour.

Something to consider when preparing for birth is your options when it comes to fetal monitoring. Regardless of where you give birth your medical staff will monitor baby, even at a home birth! This is one of the first things your care team will want to do is check how your baby is doing. Fetal monitoring helps assess your baby’s heart rate during labour to make sure they’re coping well with contractions and the birthing process. You will typically be monitored at admission when arriving at the hospital or birthing centre to establish a baseline for baby. For home births your midwifery team will check when they arrive at you home and throughout the labour.

Here are the options when it comes to monitoring, and when you can expect to encounter these options.

1. Intermittent Auscultation

Intermittent auscultation (IA) means your baby’s heartbeat is checked at regular intervals using a handheld device such as a Doppler or a fetoscope. Your care provider listens for about a minute at specific times—usually every 15–30 minutes in active labour, and more often during pushing. IA is standard practice for low risk births here in Winnipeg. If you've gone in to spontaneous labour with no complications this is how you will be monitored throughout labour.

2. Continuous Electronic Fetal Monitoring (EFM)

Continuous EFM uses belts placed around your abdomen to track both your baby’s heart rate and your contractions in real time. The data appears on a monitor or printout that your care team watches continuously. EFM provides constant data, which can be reassuring in higher-risk situations. EFM comes in when certain medications (like oxytocin or an epidural) are in play, or when there are specific health concerns for you or your baby. EFM tends to also be done for 20-30 minutes at arrival to the hospital, this is not standard with midwifery care.

Continuous EFM can limit your mobility, depending on the setup. HSC Women's Hospital does have wireless monitors, but not in every room. Remember to ask for them!

3. Internal Fetal Monitoring

If more accurate readings are needed, a tiny electrode (called a fetal scalp electrode) can be placed on your baby’s scalp after your water has broken. It gives a direct reading of your baby’s heart rate.

This type of monitoring is not standard practice and is only used when external monitors can’t pick up a clear signal (for example, if you’re moving a lot, or your baby is in a tricky position) and your provider needs more precise information about how your baby is tolerating labour.

This type of monitoring is more invasive and requires ruptured membranes.

For most people with low-risk pregnancies, intermittent monitoring is safe and effective and supports freedom of movement, comfort, and physiologic labour.

If you’re birthing in a hospital, it’s completely appropriate to ask about their monitoring policies ahead of time. Some great questions include:

• Do you offer intermittent auscultation for low-risk labours?

• Are wireless monitors available if continuous monitoring is recommended?

• How often will I be monitored during active labour and pushing?

Need help navigating your birth options? Hire a doula!