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Old 09-13-2012, 09:17 PM   #1
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Intermittent Fetal Monitoring- Natural Birth

I had DD at a birth center with a midwife. They had a portable fetal monitor that was waterproof. So when they wanted to monitor they baby wherever I was they handed me the monitor and I held it in position. I was mostly in the water and I did not like being disturbed for the majority of my labor I felt it made me lose focus. I think the nurse recognized this and she only monitored the baby maybe 6 times in 9 hours for a total of less than 5 mins each time. DD was never in distress and I was low risk.

Now on to this pregnancy. I now live 1 hour 15 mins from that birth center so I have chosen to use a midwife closer to our home who delivers in a hospital 40 minutes from our house (she is the closest, we live rural). I remembered at my visit today to ask about monitoring. She said she was fine with intermittent monitoring as long as everything stays low risk. The hospital does not offer a portable option and the hospital requires 20 mins of monitoring every hour. Seeing how last time I did not want to be disturbed during labor, let alone have to move from wherever I am comfortable to the bed to be monitored seems like a deal breaker for me. I am seriously considering switching back to the birth center and just making the drive. I just don't know if I can achieve a med-free birth if I am being disturbed. I know I have a right to refuse any treatment that I do not want so can I just refused to be monitored until I am ready?
What is your experience with monitoring in the hospital? Did you feel like it hindered your ability to concentrate and relax? How long was your labor once at the hospital?
I know so much depends on the length of labor. I was in labor for 9 hours with DD so if this little one takes that long or longer that just seems like an extreme amount of monitoring to me. If the labor is short that it really is a moot point. I just have to decide if it is worth switching care at this point. ugh..

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Old 09-15-2012, 08:29 PM   #2
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Re: Intermittent Fetal Monitoring- Natural Birth

My advice (as a L&D nurse) is to stay home as long as you possibly can if you don't want monitoring. Be very intune to your body and pay close attention to fetal movement. A baby will not move if it is too stressed. As a L&D nurse, we are (unfortunately) trained to "watch the monitor" for fear of getting sued. You don't have to go to the hospital just because your contractions are regular. Good luck
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Old 09-16-2012, 06:59 AM   #3
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Re: Intermittent Fetal Monitoring- Natural Birth

eta. Yikes I just saw that the hospital does not have portable monitors at all?! Does that mean that they don't have handheld dopplers? If that is true I would either borrow one from a midwife or OB office if possible, or hang out in the parking lot until I was pushing (or a hotel or something close by the hospital) or....I don't know. No way would I be getting monitors strapped on every hour. That's ridiculous.

I understand totally. My first birth was planned hospital birth, but we (accidentally, kind of) made it to the hospital too late for anything other than hand-held monitoring during pushing, since she was crowning when we arrived. I labored by myself for the previous 4 hours and I'm confident that being alone was what I needed to progress quickly and have not a whole lot of pain.

It wasn't until I attended a doula birth at the same hospital (now several times) that I realize how much I missed of the hospital "care", especially the fetal monitor. I don't think my labor would have been nearly as peaceful and quick with all of that stuff. I don't say that to be discouraging...just honest.

I recently had a client who did at one point refuse to get on the monitor. She ended up being on there 1.5 hours at the beginning instead of the 20 minutes because the baby was "probably sleeping, but we just need to make sure he's okay..." over and over. She didn't want to lay down in bed or have the straps around her and risk being there for an hour again, so she refused to put them back on and asked for intermittent monitoring, which they did... very very reluctantly. The hospital was reasonably accommodating of this- she had only 3 cervical checks in 14 hours and was on the monitor twice, but otherwise we were pretty much left alone. Still she told me several times that she was never coming back to the hospital to have a baby- even that was too disruptive for her comfort.

I think it's all well-and-good to tell people to wait until the last moment to go into the hospital, but since every woman's labor is different, for some women this will be much harder to judge. Your own labor pattern from your first birth might help you to decide what to do. Personally I could never drive that far, since my births are fast. We opted to have our son at home and my labor was almost just the same, but faster at 2.5 hours. I spent the entire time in the tub, by myself, not talking to anyone. My midwife checked hearttones with a handheld doppler a few times but I don't even remember it too much, so it wasn't disruptive.

So yes...you can refuse to be continuously monitored, but it's not likely to make you any "friends", and I suppose that the hospital policies would dictate how big of a deal they would make of it.Maybe the OB/midwife also? It seems like the care provider should be able to exempt you from it, but I doubt that many would do that, because of the perception of higher risk from not being monitored (ahhh...pseudoscience).
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Old 09-16-2012, 07:33 AM   #4
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I got intermittent monitoring at all four births at two separate hospitals bc I was laboring naturally and needed to be free to move around. I also requested no IV and just promised to keep hydrated. Request in writing when you register. They only checked once and a while and it didn't bother me. They won't do it too often during active labor. I always went in as late as I could though.
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Old 09-16-2012, 08:06 AM   #5
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There are national guidelines for intermittent monitoring in labor- I believe it is listening through a complete contraction cycle every 15 min during active labor and every 5 min while pushing (check out AWHONN standards). Even if they dont have a portable monitor at that hospital they can listen for brief periods rather than 20 min of continuous monitoring every hour, which would certainly be less disruptive. Our big monitors have waterproof dopplers on them, so we use them for waterbirths and women who prefer to labor in the shower. I would ask your provider if they would support you with your request for intermittent monitoring, then have it detailed in your birth requests for the nurses at the hospital. Personally I was never on the monitor for more than a couple of min and I loved not worrying about it! Good luck mama!
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Old 09-16-2012, 08:44 PM   #6
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Re: Intermittent Fetal Monitoring- Natural Birth

For my dd, i was induced for pre e and delivered at an army hospital. So i was on continuous iv fluids, continuous fetal monitoring (non stop from the moment i checked in til she was out and it was not portable) and bp checks every 15 min. This was all from the time i checked in, until she was born 25 hours later. I did succeed in having a labor/birth without any pain meds or epidural. So yes, you can still do it, its just very difficult. I am so looking forward to my planned water birth with an amazing ob at a different hospital next april. However, you are the patient and it is your body. I am not a labor and delivery nurse but i am a RN in the ER and if a patient refuses something, no matter how vital the hospital/doctor thinks it is, it is that persons right to do so and we just chart thoroughly. I dont know if it would be different on l&d because it involves a baby, but i would just make sure you have an ob that you trust and that the 2 of you are on the same page regarding all of your concerns. Hth and good luck!!
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Old 09-17-2012, 07:11 AM   #7
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Re: Intermittent Fetal Monitoring- Natural Birth

Thanks ladies! I am going to discuss how my midwife will feel if I refuse monitoring every hour (if all things are progessing normally). I want to know if monitoring every hour is something she feels strongly about. I don't mind irritating the hospital staff to much, but I would mind if it is going bother my midwife because that means we are not on the same wavelength. I really don't think the hospital staff will really care one way or the other it actually should make their job easier because it is less time they have to spend monitoring me.
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Old 09-17-2012, 09:46 AM   #8
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Re: Intermittent Fetal Monitoring- Natural Birth

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Originally Posted by Kelly3139 View Post
Thanks ladies! I am going to discuss how my midwife will feel if I refuse monitoring every hour (if all things are progessing normally). I want to know if monitoring every hour is something she feels strongly about. I don't mind irritating the hospital staff to much, but I would mind if it is going bother my midwife because that means we are not on the same wavelength. I really don't think the hospital staff will really care one way or the other it actually should make their job easier because it is less time they have to spend monitoring me.
I think that's a good plan.

Your thread has made me rethink my hospital plan altogether. My OB and I talked about intermittent monitoring at my last appt , but I didn't think to ask exactly what that meant to them. I'm also planning to labor in the jacuzzi tub. They have one in each room. So, I'm going to talk to her tomorrow what exactly is meant my intermittent monitoring. I was planning to head to the hospital fairly early on because being at home might stress me out since my 5 kids will be here and my in-laws who will be watching them and if my house is a mess, that will bother me. Going to the hospital takes all of those equations out of it. If they don't have a portable monitor and I'm going to have to be monitored on the bed for like 20 minutes of every hour, I'm going to change my plan and stay home as long as possible. I'm thinking my hospital will probably be pretty easy going about it. They are VERY naturally birth friendly. They are always happy when someone chooses no pain meds and support (even suggest) having a doula and doing things naturally.

Hopefully, it will be a non-issue for both of us!
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Old 09-18-2012, 12:42 PM   #9
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Re: Intermittent Fetal Monitoring- Natural Birth

I did intermittent monitoring with my midwives at the hospital. They were supposed to monitor every hour but didn't really stick to it, and it wasn't for 15 minutes. They used the monitor that they strap to you, they just held it on my belly for maybe 1 contraction instead of strapping it to me. It didn't bother me. I was up walking and just walked over to the machine and held it in place for a minute or 2. I didn't get to the hospital until I was 6cm either.
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Old 09-18-2012, 04:21 PM   #10
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Re: Intermittent Fetal Monitoring- Natural Birth

With my first, I didn't know I could refuse it, I hated the monitor and it was moving around so much that it really didn't seem to do much good. They had to come in and reposition it every few minutes since it would move.

With my second I expressed that I did NOT want it on, they said I could have it on 20 minutes of every hour...if they got 20 solid minutes. Well that didn't happen, the stupid thing moved all over so I had it on the whole time (which wasn't really that long since I was there less than 2 hours)

With my third I was determined not to wear it the whole time, so I laid in bed 20 minutes of every hour so I could for sure take it off the rest of the time and my labor was 3 times as long as my other 2 had been.

I am going to have a serious talk with my dr when it comes time for baby #4 about not using it as often or as long. With my first 2 it was so sporadic there is no way they were getting good readings anyway, so what is the point of putting me through that that long?

Don't get me wrong, I really enjoyed my hospital births, but that is the one thing I do not like at all.
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