If you have had a normal, healthy pregnancy with no problems so far, the midwife will listen to your baby's heartbeat using a Sonicaid. This is the small, hand-held machine the midwife or doctor uses to listen to the baby during your pregnancy.
Electronic Fetal Monitoring (EFM)
Electronic monitoring involves strapping two plastic pads to your bump. These are attached to a monitor that shows your baby's heartbeat and your contractions. A lot of hospital units now have wireless monitors. These are often waterproof so are suitable if you’re having a water birth.
You don’t need electronic monitoring if labour is going well, although you can ask for it if you want to. Your midwife or doctor will suggest EFM if:
- you have an epidural
- you have an oxytocin drip to speed up labour
- if there is baby poo (meconium) in the womb
- you have high blood pressure, a high pulse rate or develop a temperature
- you start bleeding in labour
- there is a delay in labour
- there are concerns about your baby's heartbeat.
It is your choice whether you have EFM or not. If you are advised to have it, your midwife will explain why it’s needed and what it may show.
If you’re having a home birth, you’ll be transferred to hospital. Once electronic monitoring is started, your midwife will:
- stay with you at all times
- ask you how you’re feeling
- ask you about your baby’s movements
- check the monitor regularly
- carry out any other tests that are needed.
You should also be kept fully informed about what is happening at every stage of electronic fetal monitoring.
If your doctor or midwife has started because they are concerned about your baby's heartbeat but it is found to be normal, the monitor should be taken off after 20 minutes. You can ask to keep it on if you want to.
Fetal scalp stimulation
If the EFM shows that there may be a problem, your midwife may suggest that you have a fetal scalp stimulation. This is a vaginal examination in which your healthcare professional will rub your baby’s head with their finger. This may make your baby’s heartbeat speed up, which is a reassuring sign.
Fetal blood sampling (FBS)
If the midwife or doctors are worried about your baby's heartbeat from looking at the EFM, they may want to do fetal blood sampling.
This test shows how the baby is coping with labour and measures the level of oxygen in their blood. Your midwife or doctor should tell you why they think you need this test and if there are any other options.
FBS involves having a vaginal examination, using an instrument similar to a speculum. Your healthcare professional will make a scratch on your baby's scalp and take a small amount of blood for testing. The scratch will heal quickly after birth, but there is a small risk of infection.
After the FBS, your midwife or doctor will explain the results and talk to you about what should happen next. Your options may include the following:
- carrying on with labour as normal (with electronic monitoring)
- taking a second sample
- having an assisted birth or a caesarean section as soon as possible.