1. EXTERNAL FETAL MONITORING Hanah Cummings

2. TYPES OF EXTERNAL FETAL MONITORING Fetoscope- a stethoscope with a large head designed for listening to fetal heartbeats Fetoscope- a stethoscope with a large head designed for listening to fetal heartbeats Doppler- a hand—held ultrasound device that transmits fetal heartbeats to a speaker Doppler- a hand—held ultrasound device that transmits fetal heartbeats to a speaker External EFM- an ultrasound device held against a mothers abdomen with a belt. The belt is connected to a large machine that measures and records both contractions and fetal heartbeats External EFM- an ultrasound device held against a mothers abdomen with a belt. The belt is connected to a large machine that measures and records both contractions and fetal heartbeats Telemetry EFM- Wireless version of the external EFM Telemetry EFM- Wireless version of the external EFM

3. HOW IS THE PROCEDURE DONE? Fetoscope- It is pressed firmly against the mothers stomach. Not all doctors can detect fetal heartbeats this way. This is not an option if you need continuous fetal monitoring Fetoscope- It is pressed firmly against the mothers stomach. Not all doctors can detect fetal heartbeats this way. This is not an option if you need continuous fetal monitoring Doppler- the doctor will put it up to your stomach and it will detect the fetal heartbeat while playing through a small speaker. This is good for water births, natural births or if you are walking around Doppler- the doctor will put it up to your stomach and it will detect the fetal heartbeat while playing through a small speaker. This is good for water births, natural births or if you are walking around Eternal EFM- two bands will be strapped around your stomach which will detect fetal heartbeat and contractions. You cannot walk around with this method of monitoring you are required to stay in bed Eternal EFM- two bands will be strapped around your stomach which will detect fetal heartbeat and contractions. You cannot walk around with this method of monitoring you are required to stay in bed Telemetry EFM- this is exactly the same as the external EFM except it is wireless so you can get up and move around Telemetry EFM- this is exactly the same as the external EFM except it is wireless so you can get up and move around Advantages & Disadvantages in External Fetal Monioring Advantages & Disadvantages in External Fetal Monioring Advantages & Disadvantages in External Fetal Monioring Advantages & Disadvantages in External Fetal Monioring

4. WHAT ARE THE RISKS & BENEFITS? Risks No known risks of eternal fetal monitoring during labor No known risks of eternal fetal monitoring during labor May increase your chance of cesarean May increase your chance of cesarean Benefits Can help with possible recognition of problems with the fetus Irregular heartbeat

5. WHAT ARE THE ALTERNATIVES A DOULA MIGHT SUGGEST? A fetoscope is a good alternative so you can move around A fetoscope is a good alternative so you can move around Use EFM intermittently for 10-15 minutes each hour instead of continuous Use EFM intermittently for 10-15 minutes each hour instead of continuous Use a telemetry EFM so you can still get up and move around Use a telemetry EFM so you can still get up and move around Use a hand-held waterproof telemetry so you can still get in the bath Use a hand-held waterproof telemetry so you can still get in the bath

6. HOW TO SUPPORT THE WOMAN? Let her know that this is a good way to make sure the baby’s tolerating labor well Reassure her there is no risks associated with eternal fetal monitoring Let’s her listen to the fetal heartbeat and can reduce stress in the parents

7. REFERENCES Crane, P MD; 2013. MD http://www.kidsinthehouse.com/video/fetal-distress-vs- normal-heart-rate-fluctuations Crane, P MD; 2013. MD http://www.kidsinthehouse.com/video/fetal-distress-vs- normal-heart-rate-fluctuationsMD http://www.kidsinthehouse.com/video/fetal-distress-vs- normal-heart-rate-fluctuationsMD http://www.kidsinthehouse.com/video/fetal-distress-vs- normal-heart-rate-fluctuations The Official Lamaze Guide The Official Lamaze Guide The Birth Partner The Birth Partner