Fetal heart rate monitoring

What is fetal heart rate monitoring?

Your baby's heart rate can be monitored at different stages of your pregnancy and during labour. This is called fetal heart rate monitoring.

Heart rate monitoring is done to check on your baby's health.

Fetal heart rate monitoring during pregnancy

Your doctor or midwife may ask to regularly check your baby's heart rate at antenatal appointments during pregnancy.

To listen to your baby's heartbeat through your tummy, your doctor or midwife may use:

• a handheld device called a fetal doppler
• an ear trumpet (often called a 'Pinard horn' or Pinard stethoscope)

Fetal heart rate monitoring during labour

Fetal heart rate monitoring during labour aims to check on your baby and how they are coping. It's called 'intrapartum heart rate monitoring'.

A change in heart rate during labour can be a sign that your baby needs closer monitoring and may need medical help.

Your doctor or midwife should talk to you during your pregnancy about fetal heart rate monitoring during labour. Your doctor or midwife will explain and discuss:

• the benefits and risks of monitoring
• the different types of fetal heart rate monitoring

You can make a decision together with your doctor or midwife about monitoring.

What are the different ways of monitoring my baby's heart rate?

There are different ways to monitor your baby's heart rate during pregnancy and labour.

Intermittent auscultation

Like at your antenatal appointments, your doctor or midwife may listen to your baby's heartbeat through your tummy. They will use a fetal doppler or an ear trumpet.

This is called 'intermittent auscultation' during labour and can be done at regular intervals to make sure your baby is coping well.

This type of monitoring is done during labour when your pregnancy has been low risk (healthy) and you are well.

If there are complications with you or your baby, a different monitoring method during labour may be recommended.

Continuous external monitoring

A 'cardiotocograph' (CTG) is another way of checking your baby's heart rate. A CTG gives a continuous recording of your baby's heartbeat and your contractions.

During CTG monitoring, 2 round discs containing sensors are placed on your tummy and held in place by a soft belt. Your baby's heart rate and how it changes with contractions can be monitored.

Your doctor and midwife are trained to interpret the CTG reading and to assess your baby's wellbeing.

Some CTG monitors can restrict your movements during labour. If you are advised to have continuous CTG monitoring, ask if there's one available that lets you move around.

External fetal monitoring can also sometimes be used to help doctors and midwives assess your baby's health during pregnancy.

Internal monitoring

Sometimes during labour it can be difficult to get a recording of your baby's heart rate through your tummy. Your doctor or midwife may recommend a fetal scalp electrode. This is a small clip that is placed on your baby's scalp.

Internal fetal monitoring can only be used if:

• your cervix is at least a few centimetres dilated
• your waters have broken

The electrode can be placed on your baby's head during a vaginal examination. It isn't used if there are infection risks.

What type of fetal heart rate monitoring may be recommended for my baby?

In general, deciding how to monitor your baby's heartbeat during labour depends on:

• how many weeks pregnant you are when you go into labour
• your health
• your baby's health
• your stage of labour
• how your labour is progressing
• if there is a risk of labour complications, or if complications develop

If you don't feel comfortable with any of the monitoring methods, talk to your doctor or midwife. Your doctor and midwife need your consent to do fetal heart rate monitoring.

What happens if problems are found during fetal heart rate monitoring?

If fetal heart rate monitoring during labour shows your baby may be distressed, fetal scalp blood sampling may be recommended. This involves taking a few small drops of blood from your baby's scalp (like a pin prick). It is done through a vaginal examination during labour.

Fetal scalp blood sampling can give an immediate report on your baby's condition in labour. This test would be done if more information is needed than continuous monitoring provides.

The result can help work out if your baby is unwell and may need to be born immediately.

Questions to ask your doctor or midwife about fetal heart rate monitoring

• What are the different types of fetal heart rate monitoring during labour?
• What are the benefits of fetal heart rate monitoring?
• What are the risks of fetal heart rate monitoring?
• What type of fetal heart rate monitoring would you recommend for my situation?

Resources and support

Talk to your midwife or doctor about baby heart rate monitoring during pregnancy and labour.