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Topic: Continuous electronic fetal monitor

Fiona Mcdonald
Junior Member
Member # 433

Rate Member

posted 15 September 2004 06:02 PM

Hi

I'm planning on a VBAC delivery at Royal Women's (Melb) in the next couple of weeks. I want an active labour and am concerned that the clinical practice guidelines state continuous electronic fetal monitoring throughout labour is required. I believe intermittent monitoring to be as safe. I am concerned about how I can labour actively with belts. The hospital obstetrician was dismissive of my questions. Any suggestions on how I should handle this with the hospital?

Posts: 2 | Registered: Sep 2004

Midwife Rose
Moderator
Member # 430

posted 07 October 2004 09:55 AM

Hi Fiona
Would you be having one-2-one midwifery care in labour? Firstly let me say that the research shows that you have as much chance of having a vaginal birth as any woman giving birth. Yes, there is research that indicates the earliest sign of uterine rupure is fetal heart changes, detectable on CTG and this has led to the widespread use of continuous EFM or CTGs during labour. However, close intermittent auscultation (listening with a doppler) and one 2 one care has also been shown to be safe. Many women want to move about and be active in labour, as this does maximise their chances of having a vaginal birth, and women say it is a lot more comfortable too. No doctor or health care professional should not be dismissive of your questions, or concerns. A useful thing to do is to read, talk to women who have had a VBAC and ask them what helped, get a second medical opinion if you feel you need to and on the basis of your information, and with consultation with the person (doctor/midwife who you choose to care for you, come up with a plan that suits. Sometimes this can mean signing a form which says you understand that continuous CTG monitoring has been shown to be the earliest detector of fetal heart rate changes, but there is also research that shows that abdominal pain and vaginal bleeding can be the first things to tell you that something is amiss. Some women have intermittent periods of CTG tracing, as a 'compromise' (their words). The rate of uterine rupture is less than 1%, which makes it one of the rarest obstetric complications. Other complications unrelated to a previous caesarean are likely to occur with more frequency than uterine rupture, and those complications are rare too. Hospitals around the country, and the world differ greatly in their "success rates" for VBAC. Find some with high rates of VBAC and ask what the care practices involve.
Hope this helps
Midwife Rose

Posts: 12 | From: Australia | Registered: Aug 2004

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