Both you and your baby will be checked regularly throughout labour to make sure you are both doing ok. Everything from your blood pressure and temperature to your urine and pulse will be assessed throughout the first stage.
How your baby may be monitored
Measuring her heart rate is a way of assessing your baby’s health and strength throughout labour and birth.
Different ways of monitoring
A Pinard stethoscope is a type of ear-trumpet placed against your abdomen to listen to your baby’s heart. It is used from time to time during labour.
A Doppler is a small portable machine using ultrasound for monitoring at intervals. A small transmitter-receiver is placed on your abdomen to pick up the heartbeat.
Electronic fetal monitoring (EFM) uses ultrasound waves to transmit your baby’s heart rate to a machine via a ‘transducer’ held against your abdomen. Alternatively, a small electrode can be clipped onto your baby’s scalp (or bottom, in a breech baby) and this picks up and transmits the heartbeat. The heart rate usually appears in digital form on the screen, and a record is traced on graph paper and printed out.
Telemetry uses the same sort of transducer or scalp electrode, but sends signals by radio waves to the receiver. You’re not actually attached to the monitor by wires, so you are free to move around as long as you stay within its range.
Electronic fetal monitoring
EFM monitors the baby continuously. For some babies this can be important – if the baby is at risk or if it’s known that there may be a problem. In most cases, continuous EFM is not very useful in uncomplicated labour. Interpreting the monitor reading is a highly skilled job. Even very experienced obstetricians differ in opinion about what is a ‘normal’ reading, and what may give cause for concern. In many hospitals midwives agree that continuous EFM is not needed for normal labour, especially in the first stage.
EFM is necessary when an intervention such as induction, or an epidural, is undertaken as these may cause stress to the baby. If you and your carers expect everything to be normal, you may prefer to have the other forms of monitoring with a Doppler or a Pinard stethoscope. You’ll probably find your baby’s heart is listened to every 15 or 20 minutes, and after most contractions in the second stage.
Checks you will have
You can expect the following things to be assessed regularly throughout the first stage:
- your blood pressure, pulse and temperature
- your urine (to help check your energy levels)
- the length, strength and frequency of your contractions
- possibly your cervix through an internal or vaginal examination.
An intense stage of the birth, sometimes referred to as ‘transition’, comes between the first and second stages. Many women clearly experience it as different from other parts of their labour.
You may feel an urge to push or you may feel that your labour has stopped altogether. Your midwife will guide you through this stage, helping you through your contractions and encouraging you to find the best position.
Transition is a psychological state as well as a physical one and it can be very intense. You may feel impatient, tired, irritable and even angry and frustrated with your carers and birthing partner. This is a perfectly natural reaction and it means that the birth of your baby is not far off.
Remember it’s ok to let everyone know how you are feeling.
If you don’t want anyone to touch you, including your birthing partner, let them know.
Using the breathing techniques you have learned may help keep you calm between contractions.
Your partner should know not to take your frustrations and irritability too personally – you’re both nearly there!