Your doctor may choose to perform fetal monitoring during pregnancy or labor if any of the following occurs:
- You have anemia.
- You have a history of heart disease, diabetes, or hyperthyroidism.
- You have oligohydramnios.
- You’re obese.
- You’re carrying more than one baby.
- You go into labor before 37 weeks.
- You go into labor after 42 weeks.
- Your baby moves into a breech position, which means feet or buttocks first
Fetal monitoring usually doesn’t harm babies, but this method has some risks. It’s important that you and your doctor consider these risks before using fetal monitoring.
Risk of infection
Your doctor must insert a gloved hand into the cervix to attach the transducer to perform internal fetal monitoring, This increases the risk of infection because bacteria from the glove, your tissues, or your blood can spread to the baby. Due to this risk, internal fetal monitoring isn’t recommended for women with infections that could potentially spread to the baby.
Risk of fetal injury
During internal fetal monitoring, your doctor tries to place the transducer on the baby’s scalp as gently as possible. In some cases, the transducer might cause some injury to your baby. Examples of potential injuries include bruising and scratching. These markings typically heal quickly without any complications.
Risk of assisted delivery complications
Fetal monitoring gives doctors more information about your baby’s heart rate during labor. This information can be helpful, but it may sometimes create unnecessary concern. In some cases, it might be difficult to determine whether your baby is in true distress or whether the monitor just isn’t reading their heart rate accurately. When fetal monitoring indicates the baby is distressed, doctors tend to err on the side of caution. They’re more likely to perform an assisted delivery to help prevent complications in the baby. Examples of assisted deliveries include:
- a cesarean delivery, which involves making one incision in your abdomen and another in your uterus to deliver your baby
- a vacuum-assisted delivery, which involves using a vacuum-like device to help ease your baby out of the birth canal
- a forceps-assisted delivery, which involves using large, curved tongs to gently pull your baby out of the birth canal
While these delivery methods are widely used and may be necessary, any extra interventions increase the risk of complications. For the mother, these may include:
- heavy bleeding
- tears or wounds in the genital tract
- injuries to the bladder or urethra
- problems urinating
- a temporary loss of bladder control
- a severe infection
- an adverse reaction to anesthesia or medication
- blood clots
For the baby, these may include:
- breathing problems
- nicks or cuts
- bleeding in the skull
- minor scalp wounds
- a yellowing of the skin and eyes, which is called jaundice
Your doctor should always discuss the risks and benefits of assisted delivery with you before you give birth.