EFM - is there ever a need for it?

[meitaimama]

I've been lying awake at night worrying about giving birth in a hospital again even though it's a long way off.

I am planning on refusing any continuous foetal monitoring... from what I've read, there's never a need for it, and it only increases your chance of a c/s.... but I know that DH and I will probably find ourselves being told that we HAVE to have it, if there is a complication of any sort (e.g. last birth I had PROM and was slightly febrile and the midwives seemed to freak out) or we will be putting our baby in danger. Please give me some ammunition for all eventualities.... is there really ever a good reason for it?

Thanks!

Sarah

[skn]

Have you considered a doula when the time does happen? I loved my doula for my last labour/birth- she allowed me to stay in that birthing zone, without having to worry about stupid questions and unnecessary intervention.

My last labour/birth was pretty good. From what I can remember very little interference from the midwife, apparently she'd just stand and watch every now and then and then would go off somewhere. I think she used a doppler a couple times

Birth plan is another good thing.

Also, what have you been reading? I recommend "Pushed" by Jennifer Block (talks more about the politics of birth, but gives interesting studies about intervention). Also "Gentle Birth, Gentle Mothering" and "New Active Birth".

BRAN can be a good thing to remember if you are faced with hospital staff trying to push something on you
B- benefits of what they are proposing
R- risks associated
A- alternitives
N- what if nothing is done?

I just said no EFT- doppler if needed, as I wanted to remain mobile and that seemed to be enough for them.

[kadownie]

I would say if a Mum is having synto in her labour then it is necessary to monitor.. due to the unnatural actions of synto and the possibility of stressing bub out..

other than that- I can't think of any real reason...though I'm sure they may be a few..

why do you think you would need continuous monitoring because of PROM in your previous birth?? Are you giving birth in a private hospy, as ob's prefer their births to be monitored..

[skn]

I went a little off topic, didn't I?!

Ditto to what Kylie said, though for a natural labour/birth I can't think of why you'd need one.

[hanabi]

There is no evidence that CFM offers any advantage over doppler and rather a lot of evidence suggests CFM can be detrimental to your outcomes. You'd be rendered immobile and left to labour while staff place their trust in the trace from the monitor. This increases the risk of false diagnosis of foetal distress.

PROM and a fever would certainly require more monitoring and pre-emptive response to a bad heartrate. But with a normal onset of a term labour, CFM is overkill.

[meitaimama]

Thanks for your replies! Kylie, I read New Active Birth in my first pregnancy and thought it was great, but it didn't really give me the information I needed to make an educated decision about accepting/refusing intervention.

We are birthing at a public hospital birth centre (if we could afford private care we would be having a HB! Private hospitals seem to be a one-way street to a c/s from what I've seen with the care some of my friends have had....). Last time we were at a different public hospital and a lot of the care was great, but the admitting midwife insisted I lie down on my back for external foetal monitoring.... I had a posterior baby and could not handle this - I went from being calm, focussed and 'on top' of my contractions to shaking uncontrollably and shouting 'get this 'f***ing this off me!'

Of course, she then diagnosed problems with the foetal heart rate (decels because of the lack of fluid to cushion her, apparently) which led to more panic and intervention etc etc.... I don't mean to be blase, because maybe we really did need monitoring and intervention, but I was in labour for about 12 hours after this and the baby was in no distress. The baby's ph levels were checked later and she was fine. This was the good thing about the hospital staff - despite all the high-tech monitoring etc they were really pro-vaginal birth and I was encouraged to wait as long as possible for her to turn and descend.

This time I just want to be able to say 'No EFM' because I know how I feel in labour now and I HAVE to stay mobile.... but i have a feeling I will be told "I know you said 'no EFM' in your birth plan but we need to do it because.....' (insert obscure complication we never heard of.

Sarah

[Deesalie]

I had it for my 1st, then down right refused with my 2nd, telling them they could use the hand held monitor instead. Initially I was met with resistance, spouting hospital policies etc, but once they realised I wasn't going to budge, they managed to dig up a hand held dopler. From then on it was smooth sailing as I was mobile Just stand up for yourself...

[emd]

If they plug you into a synto drip, or use gel to induce labour, you would be wise to have at least intermittent monitoring. This is because the artificial hormones can cause unexpected consequences in some women, and the monitor can pick up early warning signs.

But as Jodie said, with a normal onset of labour at term, there should be no need for CFM.

[Nyree]

I wish I had known I could refuse a CTG trace with my first. I just wated to move around but was stuck in a chair with the stupid thing strapped on my belly. Because I was unable to move throuh contractions, I was sucking back on more & more gas and the whole thing was just not how I wanted it. I asked a middy to remove it, but she said they 'needed' a few more minutes worth. Grrrr!!! My BP was up, so they wanted to keep a closer eye on things, apparently. If I end up in hopsy again next time, I will be the one telling them how it's going to be, but I'm planning a HB anyway

It may be of more benefit if there are obvious signs of distress/risk factors.

[MindfulMama]

We had it for DS as he was born at 34 weeks. We were told we couldn't refuse, and TBH it wasn't worth arguing against (as highlighted by our BC midwife it's important to pick your battles ). Turned away from me with the sound down I ignored it the whole time. I still moved around - just took the machine with me. If I wanted a break I said I needed to go to the toilet. The major downside was not being allowed to use the shower for pain relief (& the psychological aspect of having something medical attached to me, but given I also had a bung in, the monitoring was inconsequential). In the end it was actually of benefit as we were able to argue against a c/s as we could show that DS was coping with the labour