If you're reading this, you're probably planning to give birth in the UK, US, Canada or Australia. Continuous monitoring of a baby's heartbeat in labour has become standard practice in these countries (and most industrialised countries worldwide). This procedure, known as cardiotocography (CTG) monitoring, involves strapping two probes to your belly, one to record baby's heartbeat and one for your contractions. While CTG monitoring may seem like a reassuring measure on paper, there are some serious problems with its use and a very good chance you won't be warned about them beforehand. So let's nip that in the bud, shall we? Keep reading to learn the 3 things you need to know about checking your baby's heartbeat. This information will help you make an informed decision and keep your baby (and yourself) safer during birth.
1. CTG Monitoring and Restricted Movement
CTG monitoring is often the primary reason for restricting your movement in labour. Research, including my own where I interviewed UK hospital midwives, consistently shows that once the CTG probes are in place, staff will prioritise obtaining a clear recording of the baby's heartbeat over your comfort and need to move your body.
You see, the more you move the more challenging it becomes to track baby's heartbeat for the machine. This becomes a problem for the midwives/nurses. Even though moving freely is the best thing for you and baby, their managers will not see it that way (litigation, defensive practice, and all that jazz). As a result, they'll ask you to stay still, to move less, to find a position that works better for the monitor, to become less instinctual and little by little you may just find yourself laying on your back on the bed, the optimal position for the machine and handsy professionals. Please, mama, don't overlook this intervention.
RESTRICTING YOUR MOVEMENT IS A HUGE DEAL IN BIRTH!! Moving freely is one of the most effective ways to stay on top of your pain levels and to promote an easier, quicker birth in every possible way. Interfering with your freedom to move and your instinct to find the best position at each stage of the process can have a massive impact on your birth experience and type of birth.
"But if it keeps my baby safer..." I know, mama. I hear you. So let's look at safety next.
2. The Myth of Safety
Contrary to popular belief, strapping a mother to a machine to record every baby's heartbeat has never been proven to make birth safer! We've been using these monitors for 50+ years and still can't prove they're helping!! In fact, studies have shown that continuous CTG monitoring doesn't reduce baby injuries and deaths but it increases the rates of caesarean sections and instrumental births (forceps or ventouse), resulting in more trauma for mothers. With no reassuring evidence behind it, CTG monitoring mostly provides a false sense of security and increases risks for mothers. Surely we should at least have this information and time to think about it before we accept this routine intervention without question, right?! Keep reading, I'll give you a great alternative to CTG monitoring at the end.
3. CTG and High Risk
International guidelines recommend CTG monitoring for all babies deemed at higher risk of complications, but the evidence supporting these recommendations is quite poor (do you see a theme here?). The list of risk factors to label mothers "high risk" and advise they be strapped to machines is ever growing...mamas with higher BMIs, with previous caesarean births, carrying smaller babies or with longer pregnancies just
to name a few... But there's no robust research to show that these mamas and babies benefit from more monitoring (and less movement) in birth. Most of these recommendations are based on cultural norms and experts' opinions, with no proof we're helping anyone. Crazy, eh?! If you've been told you're "high risk" (and a lot of athletes are), don't worry about the label, mama. Look at your situation as the beautiful, unique individual you are with a specialist you trust. The great news is that while the guidelines suggest lots of different things, any maternity professional worth their salt can help you look at what the research actually says and make choices that feel right for you and your family! Want more great news? Keep reading for my bonus tip!
Bonus Tip - The Alternative To CTG
By now you're probably thinking, WTAF? CTG monitoring doesn't sound great but what can I do instead? How do I keep my baby safe without being strapped to a bed? Here it is!! There is a safe, simple alternative to CTG monitoring that is evidence based. It's a viable alternative for most mamas, wherever you give birth and it's called Intermittent Auscultation (IA). This method involves regularly listening to the baby's heartbeat between contractions using a handheld Doppler device (the same little machine your midwife uses at your pregnancy check ups).
