What Is Fetal Heart Monitoring?

Your doctor will use fetal heart monitoring to check on the status of the baby during labor and delivery. It can also be done before labor and delivery, as part of routine screening at the very end of pregnancy, or if you notice a decrease in your baby’s kick count. An abnormal heart rate may be a sign that your baby is having health problems. There are three different ways to monitor your baby’s heartbeat, including: auscultation, electronic fetal monitoring, and internal fetal monitoring.

External Fetal Heart Rate Monitoring

There are two different ways to monitor your baby’s heartbeat externally.


Fetal auscultation is done with a small, hand-sized device called a transducer. Wires connect the transducer to a fetal heart rate monitor. Your doctor will place the transducer on your abdomen so that the device will pick up your baby’s heartbeat.

Your doctor will use the transducer to monitor your baby’s heartbeat at set times throughout your labor. This is considered routine for low-risk pregnancies.

Electronic Fetal Monitoring (EFM)

Your doctor will also use EFM to monitor how your baby’s heart rate responds to your contractions. To do this, your doctor will wrap two belts around your abdomen. One of these belts will record your baby’s heart rate. The other belt measures the length of each contraction and the time between them.

Your doctor will most likely only use the EFM device for the first half hour of your labor if you and your baby seem to be doing well.

Risks and Limitations of External Fetal Monitoring

Auscultation is only used periodically throughout your labor and has no limitations. However, EFM requires that you stay very still. Movement can disrupt the signal and prevent the machine from getting an accurate reading.

The routine use of EFM is controversial in some hospitals. Some experts believe that routine EHF is unnecessary in low-risk pregnancies.

EFM can limit your movement during labor. Studies have shown that freedom of movement in labor makes delivery easier for most women.

Some experts also feel that EFM leads to unnecessary cesarean deliveries or the use of forceps or vacuum during vaginal delivery.

Internal Fetal Heart Rate Monitoring

This method is used if your doctor is unable to get a good reading from EFM, or if your doctor wants to closely monitor your baby.

Your baby’s heart rate can only be measured internally after your water has broken. Your doctor will attach an electrode to the part of your baby’s body that is closest to the cervical opening. This is usually your baby’s scalp.

They may also insert a pressure catheter into your uterus to monitor your contractions.

Risks and Limitations of Internal Fetal Heart Rate Monitoring

There is no radiation involved in this method. However, the insertion of the electrode may be uncomfortable for you. The electrode may also cause bruising on the part of the fetus that it is attached to.

This method is not recommended for women who have active herpes outbreaks when they are in labor. This is because it can make it more likely that the virus will be transferred to the baby. It should also not be used in HIV-positive women, due to the risk of infection.

What Happens if My Baby’s Heartbeat Is Abnormal?

It is important to remember that an abnormal heart rate does not always mean that there is something wrong with your baby. If your baby develops an abnormal heart rate, your doctor will try to figure out what is causing it. They may need to order several tests to figure out what is causing the abnormal heart rate. Depending on the test results, your doctor may attempt to change the position of your baby or give it more oxygen. If these methods don’t work, your doctor will most likely deliver your baby through a cesarean, or with the help of forceps or a vacuum.