Fetal monitoring in labour: the care you should expect
Wherever birth happens (at home, in a midwifery-led unit, or in an obstetric unit), monitoring the wellbeing of the woman and baby during labour is an important part of intrapartum care. Risk assessment, and informed advice from the care team, can help a woman decide the most appropriate type of monitoring for their baby. The 2 types of fetal monitoring are called intermittent auscultation (listening to the baby’s heartbeat; this is done every 15 minutes, or more frequently if needed), and cardiotocography (sensors that detect the baby’s heart rate and your contractions are attached to you, or sometimes to both you and your baby).
We want this guideline to make a difference to women, their babies, and families and carers by making sure care teams know:
- what information the woman needs to make informed decisions about fetal monitoring, and to support her choices
- what assessments should be done during labour, when they should be done, and what action to take based on the results
- how to work out how well the baby is coping with labour
- what risk factors to look for during labour, how to categorise them (using a white, amber or red colour-coded system), and how to use these results to work out the overall level of risk
- the advantages of having the results of assessments and fetal monitoring regularly reviewed by other members of the care team.
Making decisions together
Decisions about treatment and care are best when they are made together. Your healthcare professionals should give you clear information, talk with you about your options and listen carefully to your views and concerns. They should also:
- explain how assessments done during labour and the fetal monitoring results go together to form part of an overall picture of you and your baby’s health
- discuss the 2 different monitoring methods with you, including the issues associated with each type (for example, how much you will be able to move about during labour)
- help you decide on the most appropriate level of monitoring for you and your baby
- explain what actions may be needed and why, depending on what the fetal monitoring and risk assessment results show.
If you can’t understand the information you are given, tell your care team.
Read more about making decisions about your care.
Where can I find out more?
The organisations below can give you more advice and support.
- AIMS (Association for Improvements in the Maternity Services), 0300 365 0663
- Birthrights, email@example.com
- NCT (National Childbirth Trust), 0300 330 0700
- Tommy’s, 0800 0147 800
NICE is not responsible for the content of these websites.
To share an experience of care you have received, contact your local Healthwatch.
We wrote this guideline with people who have had fetal monitoring in labour and staff who treat and support them. All the decisions are based on the best research available.
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