Hello, mkk-ga!
What an interesting question! Since I had natural childbirth with
all three of my children, I always love questions about pregnancy and
what methods might be the least stressful to the mother and baby.
First of all, before I begin, I suggest you visit the
Childbirth.org website. It offers a wealth of information on all
topics of pregnancy and childbirth. The site can be found at
www.childbirth.org. The following information comes from their site:
“Non-stress tests” are usually done by electronic fetal monitoring,
using an ultrasound device during labor and delivery to monitor the
baby’s heart rate in relation to the mother’s contractions. However,
non-stress tests using the electronic monitor may also be done in
prenatal visits if necessary . The other types of fetal monitoring are
doppler, fetoscope, telemetry monitoring and internal fetal
monitoring. All can be used during labor and delivery, but not all
would be used in a prenatal office visit.
Doppler uses a handheld ultrasound device attached to a speaker or
earphones, which magnifies the sound of the baby’s heartbeat. It can
be used in a prenatal office visit to hear the baby’s heartbeat at
approximately 12 weeks, or can be used during the labor process,
allowing the mother mobility because it requires no invasive
procedures. Since it does not provide continuous monitoring, however,
it is not for high-risk mothers during delivery
A Fetoscope is a special type of stethescope which can also be used
during prenatal office visits to listen to the baby’s heart beat at
approximately 18 weeks. It is non-invasive, allows mobility during
labor and delivery, but is also not used for high-risk mothers, since
it does not provide continuous monitoring.
Telemetry monitoring is used during labor, and is considered the
“newest” form of monitoring. Telemetry uses radio waves which are
connected to a transmitter on the mother’s thigh, transmitting the
baby’s heart tones to the nurse’s station. It is non-invasive, and
allows the mother mobility during the labor process. It does allow for
continuous monitoring.
Electronic monitoring (which can also be used during a prenatal
“non-stress” test) uses an ultrasound device to record the baby’s
heart beat and /or the mother’s contractions. Since the monitor is
hooked up to a machine during labor, there is loss of mobility for the
mother. Secondly, since the monitor records the baby’s heart rate
“beat-by-beat,” attention can often be focused more on the recording
machine than on the mother, leaving the patient feeling somewhat
detached from the process. There is also the possibility of incorrect
interpretation of information.
Internal fetal monitoring is the most invasive, since it requires
electrodes to be placed on the baby’s head during labor. The
electrodes monitor heart rate and a pressure catheter records
contractions. The mother is immobilized, dilation of 2-3 centimeters
must be present and the water must be broken before the electrodes can
be attached. Internal monitoring is reserved primarily for high-risk
deliveries.
Please refer to the article at
http://www.childbirth.org/articles/efmfaq.html
The main concern surrounding fetal monitoring, which goes along
with your question, is whether pregnancy outcome is improved with any
of these tests, especially if they can be done in a routine office
visit in a less invasive manner and allow a more willing attitude in
the pregnant mother. The answer seems to be summed up best this way:
“The problem with standard fetal monitoring is that we tend to want
to use continuous fetal monitoring on everyone. However, today we know
that in most cases, routine continuous fetal monitoring of every woman
does not improve fetal or maternal outcomes, it only tends to increase
the cesarean rates. We have found that using a fetoscope or doppler is
just as effective in predicting fetal well-being.”
Please read the article cited from the Childbirth.org website, which
not only goes over this information in detail, but includes personal
stories on fetal monitoring and an abundance of cited research
articles for further exploration.
“Monitoring FAQ” http://www.childbirth.org/articles/efmfaq.html
Additionally, the prenatal non-stress test done today has, in most
instances, replaced the more invasive OCT (oxytocin challenge test).
The OCT test is done during the final weeks of pregnancy, hooking the
mother up to an IV line which drips Pitocin to start false
contractions while a fetal monitor records the baby’s heart beat. This
test (an awful prospect, in my opinion) is administered to see how the
baby might “handle” the impending labor. If the heart rate is too high
during testing, it is supposed that the baby is undergoing too much
stress. There is a fairly high rate of false positives, which can lead
to a decision for labor induction or cesarean birth, and considerable
risk to the mother, including initiation of early labor due to the
Pitocin.
The non-stress test, again, is not a routine prenatal test but is
normally performed after the mother’s due date. It is considerably
less invasive than the OCT test. However, there are also real
possibilities for false positives indicating fetal stress, leading
toward intervention when none is needed.
You can read about both tests in more detail at “Ask a Childbirth
Educator”, http://www.childbirth.org/AskACBE/labor/labor18.html
I hope this information is helpful. While every pregnancy is
different, and risky situations should be monitored in every way
possible to ensure a healthy outcome, it would seem that the least
invasive testing procedures in the most comfortable environment for
the mother would be the most desirable. In most cases, healthy mothers
and babies can be monitored accurately with a stethescope or
fetalscope throughout pregnancy and the birthing process, leading to
happy smiles all around when the new baby finally greets Mom and Dad.
umiat-ga
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