Why should I take the test?💡

Fetal heart rate monitoring, which is also called EFM, allows your healthcare provider to track your baby's heartbeat later in your pregnancy and when you are in labor. When your pregnancy is high-risk after 20 weeks of gestation, the test is combined with other tests for a closer look if you have diabetes, high blood pressure, or any conditions that affect your health and show your baby is not growing normally. 

How is the test done?💉

The doctor can monitor your baby's heartbeat through external monitoring or internal monitoring. External EFM is the most common type. 

External monitoring (auscultation) 

If your pregnancy is going normally, your doctor will put a clear gel on your belly. Then the doctor will likely check your baby's heart rate by using elastic strips to secure two measuring devices to your abdomen. An ultrasound device like a special stethoscope or a hand-held device called a Doppler ultrasound is positioned over your abdomen to measure fetal heart rate.

A pressure gauge placed at the top of your abdomen measures the frequency of your contractions. If these contractions are stressing your baby, you might have to have your baby as soon as possible. 

Internal monitoring

Once your water breaks and your cervix opens to prepare for birth, you put your feets and legs in support. The doctor will feel your baby's head, then put a thin catheter with a small wire at the end into your vagina. The wire connects your baby's head with a monitor and records the heartbeat. The doctor removes the catheter and the wire when the baby is about to come out.

TMI from Baby Billy👩‍⚕️:

Fetal heart rate monitoring results

A healthy baby's heart usually beats 110-160 times a minute in the womb. Abnormal patterns do not always mean something is wrong with the baby, but they can be good signs that the baby is under stress or not getting enough oxygen.

The result may be less valid if you are obese. Having too much amniotic fluid and both you and the baby in the wrong position also affect the accuracy of the result. 

Risks of the procedure

External monitoring is not risky since it does not hurt or use radiation. If the doctor uses a belt to fix you, it might be a bit uncomfortable. In cases of false alarms, false concern for fetal distress can result in unnecessary cesarean section or operative delivery.

Internal monitoring carries additional risks such as injury to your baby's scalp, maternal infection, transmission of HIV or other STIs from the mother to the baby. Despite rare circumstances, the catheter inserted into your uterus can become tangled with the umbilical cord or tear the placenta. If you have other health conditions, let your doctors know to prevent any special risks.