From Giving Birth with Confidence.
- Routine continuous Electronic Fetal Monitoring (EFM) provides no benefit for babies and increases the risk of instrumental (e.g. use of forceps) vaginal births and cesarean deliveries.
- The American College of Obstetricians and Gynecologists (ACOG) recommends that for healthy, low-risk births (most births), fetal heart rate be monitored with a fetoscope or Doppler stethoscope every 30 minutes in active labor and every 15 minutes during pushing.
- The World Health Organization (WHO) encourages intermittent manual listening and warns that EFM is often used inappropriately.
You May Need Continuous EFM If...
- Your labor is induced or sped up with Pitocin.
- You have an epidural.
- Your baby’s heart rate changes.
- You or your baby has a health problem.
How to Avoid Unnecessary Continuous EFM
- Remember that routine use of continuous EFM doesn’t make labor safer for your baby.
- Find a caregiver who doesn’t use continuous EFM routinely.
- Talk to your caregiver about intermittent fetal monitoring.
- Stay at home as long as possible in labor.
How to Keep Labor as Safe and Healthy as Possible if You Need Continuous EFM
- Remember that your body knows how to protect your baby during labor.
- Continue to move as much as possible, both in and out of bed.
- Ask staff to turn off the monitor’s sound.
- Ask staff to turn the monitor away from you and your helpers so it doesn’t distract you.
- Ask for a telemetry monitor (that is, one that's not attached by wires to the machine).
- Ask to be disconnected from the monitor for regular trips to the toilet.
- Remind your helpers that you are the one in labor, not the machine.