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Fetal Monitoring?

Last post 05-18-2009 11:19 AM by intothesehands. 3 replies.
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  • 05-04-2009 5:36 PM

    Fetal Monitoring?

    Can you feel the baby's heatrate with a finger on the fontonel when the baby is crowning?  I believe I have witnessed this at a homebirth so I have always assumed so.   I ask this question, as a doula, because I have witnessed several births where the baby's heartbeat could not be picked up with the doppler as the baby came to a long crowning which caused either nervous energy from the care provider (out of hospital) or an internal monitor to be attached (hospital).

  • 05-04-2009 6:16 PM In reply to

    • midwifea
    • Top 10 Contributor
    • Joined on 02-12-2009
    • Kailua Kona, HI
    • Posts 475

    Re: Fetal Monitoring?

    Michelle,

    Absolutely, Fontanel pulse, scalp color, fetal movement are all good indicators when a doppler or fetoscope are inadequate.  Besides, if a baby is crowning, what are you going to do?  Baby has to be born.  I can't imagine inserting a fetal scalp monitor at that late time in birthing!

    Blessings,
    April
    moderator

    "The Voice

    There is a voice inside of you
    That whispers all day long,
    "I feel this is right for me,
    I know that this is wrong."
    No teacher, preacher, parent, friend
    Or wise man can decide
    What's right for you--just listen to
    The voice that speaks inside."
    — Shel Silverstein
  • 05-14-2009 1:45 PM In reply to

    Re: Fetal Monitoring?

     That's very exciting and I must try that.  As a homebirth midwife, of course there is not the option (or desire) to put in a scalp electrode, but a midwife might be so anxious that on a primip where she can't find the FHR and just wants that baby out, she might cut an unnecessary episiotomy instead of just waiting out a long crowning.  Ilana Shemesh

    Ilana Shemesh, RN, homebirth midwife
  • 05-18-2009 11:19 AM In reply to

    Re: Fetal Monitoring?

     Yes of course it's possible to get a fetal scalp pulse...

    One of my first births as an apprentice (and after I'd been an L&D nurse for a couple of years), my mentor was serving a primip momma who had the -s l o w e s t- crown I'd ever witnessed.  After several hours of pushing and with no luck getting hearttones via doppler or fetoscope (the room was becoming quite tense with worry) it occurred to me that I should try feeling the babe's little head (I mean if they place an electrode there, why couldn't we palpate a pulse?)  Sure enough I was able to count it out...100-110 during a contraction and a return to the 120's afterward!  Of course the head compression had lowered her from baseline, but it was still within normal limits...so we all relaxed and encouraged momma to just continue easing her baby out.  Daddy caught his daughter over an intact perineum less than an hour after that.  Her apgars were 9 & 10.

    I never hesitiate to employ this method when feeling the need for reassurance that babe is okay for the long haul of a slow crown :)

    "Always Trust The Process"
    http://www.intothesehands.com
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