Labor is no cakewalk for you — and it isn't for your baby either. During labor, your baby will be squeezed by your strong uterine muscles, then pushed and molded as he or she makes the journey though your narrow pelvis and down the tight birth canal. While most babies weather the storm of childbirth like little troupers, others find the stress of labor too difficult, and respond with decelerations in heart rate, rapid or slowed down movement, or other signs of fetal distress. Periodically assessing how your baby is handling the stresses of labor is important to ensure the safety of your baby. And happily, the latest research shows that for low risk, unmedicated deliveries, intermittent fetal heart checks using a Doppler or fetal monitor is an effective way to assess fetal condition. Which means if you fit in that category, you probably won't have to be attached to a fetal monitor for the entire duration of your labor.
On the other hand, if you're being induced, have opted for an epidural, or have other risk factors at work, chances are you'll be hooked up to an electronic fetal monitor — probably throughout your entire labor. There are three types of continuous fetal monitoring:
External monitoring: An ultrasound transducer is strapped over your abdomen to pick up the baby's heartbeat. A second detector is strapped to the top of your abdomen to record the frequency and power of your contractions. Both are connected to a monitor, and the measurements are recorded on a paper readout. These two measurements give your practitioner detailed information about how your baby is handling labor.
Internal monitoring: If your cervix is sufficiently dilated (one to three centimeters), your bag of waters is no longer intact, and more accurate results are required (such as when there is reason to suspect fetal distress), you might be hooked up to an internal monitor. A tiny electrode is inserted through your vagina onto your baby's scalp and a catheter is placed in your uterus or an external pressure gauge is strapped to your abdomen to measure the strength of your contractions. Though internal monitoring gives a slightly more accurate record of the baby's heart rate and your contractions than an external monitor, it's only used when necessary (since there is a slight risk of infection).
Telemetry monitoring: Available only in some hospitals, this type of monitoring uses a transmitter on your thigh to transmit the baby's heart tones (via radio waves) to the nurse's station. The benefit to this type of monitoring is that you maintain your mobility while still having constant monitoring.
Do keep in mind that when it comes to fetal monitoring, false alarms are common. The machine can start beeping loudly if the transducer has slipped out of place, if the baby has shifted positions, if the monitor isn't working right, or if contractions have suddenly picked up in intensity. Your practitioner will take all these factors and others into account before concluding that your baby is in trouble. If your fetus does seem to be in danger, further tests will be run or a cesarean will be performed.