If you are in your pregnancy, your doctor probably wants to make sure your baby is healthy and growing as he/she should. One of the ways they do that is to check the rate and rhythm of your baby’s heartbeat through Fetal heart rate monitoring. 

What Is Fetal Monitoring?

Fetal monitoring is a method to tell how your baby is coping with labor. Electronic fetal monitoring came into use before being thoroughly tested for reliability, but the idea behind it was that it would provide a graph to check how the baby’s heart rate responded in combination with a contraction. It also allowed the monitoring to be done without any added one-on-one care at the bedside.

Reading A Fetal Monitor To Understand Your Labor

Nowadays fetal monitoring has a variety of ways it can be done. It can be done either externally or internally. It can be also done continuously or intermittently. Intermittent monitoring with either an electronic fetal monitor, a handheld doppler, or a stethoscope can be put to use for low-risk women.

What Does Electronic Fetal Monitoring Measure

Electronic fetal monitoring puts displays on a computer monitor, or a paper graph, that records both the fetal heart rate and the mother’s contractions.  You can generally see the fetal heart rate marked with a blue indicator. The red indicator shows the mother’s contractions.

The fetal heart rate is usually displayed on the top of a computer screen, and the contractions are on the bottom. Graph paper has the fetal heart rate printed to the left and the contractions to the right. However, it is easier to read these by looking at them sideways so that they resemble the graph above.

The monitoring strip for your labor room and those of all other labor rooms are also visible from a bank of monitors at the nurses’ desk. This allows the staff to watch all the monitors without entering your room.

Y-Axis of Fetal Monitoring: On the left-hand side, there is the y-axis in each of the graphs. The blue indicator shows you the marking of the fetal heart rate. These are in beats per minute (bpm), measured in increments of ten with markings every 30 beats.

On the left at the bottom with the red indicator, you can see the y-axis measures millimeters of mercury (mmHg). This is supposed to measure the degree of the contraction, with the higher number being a stronger contraction. Unless you use an internal uterine pressure catheter (IUPC),2 this is simply going to provide a graphical representation of each contraction.​

The x-Axis of Fetal Monitoring: The horizontal line, or the x-axis, is measured in minutes. Between the blue and red indicators, is one single minute. Within each minute are lighter lines, each of these measures a ten-second increase. This means that there are six sections for every one minute.

Merging the top and bottom (x and y-axes) graphs, the graphs will line up such that the heart rate directly above the contraction is happening at the same time.

It can every so often be difficult to imagine all of this until you are actually in labor. Once there, ask your nurse, midwife, or physician for a quick brief of the fetal monitoring strip or monitor. They will be more than happy to help you learn to watch your baby’s heart rate with them.

Fetal Monitor
Fetal Monitor

What Type of Monitoring Is Best for You?

The truth is that there is no one particular type of fetal monitoring for every woman. The amount of time between checking on the baby and labor will vary from woman to woman and even labor to labor. If you are having high-risk labor, you likely need to have continuous fetal monitoring during pregnancy. This can include:

  • Women having an induction of labor
  • Women who had a previous cesarean birth
  • Women with an epidural
  • Women who are expecting multiple babies
  • Women having medical problems
  • Women who have experienced some form of fetal distress in the present labor

Talk to your doctor during your pregnancy about how they use fetal monitoring and when it may need to be used continuously, or when you may need to look at using internal fetal monitoring.