a question about laboring at home...

Holly_1007

with DS I only labored at home for a little while, we had a 45 min car ride in a snow storm so I preferred to get to the hospital earlier rather than later.  I was hooked up to the monitors for most of the time I was there due to his random heart decels, listening to his heartbeat and being able to know that he was doing okay was SO soothing to me!

This time, I'm delivering at a hospital with OB again (the only thing my insurance covers) but we are only 10 mins from the hospital and I'm hoping to labor at home a lot longer.  The only thing I'm nervous of is not being able to hear the babys heartbeat, did anyone else purchase or rent and actually use a doppler while laboring at home?

wannabigfam

Nope.  I didn't worry about it at all and was only monitored for about 2 min my whole labor.

sschwege

My CNMs just advised me to make sure I was feeling the baby move between contractions and to trust my instincts if something didn't seem right to come in earlier.   

BLuvsE

Can you hear it with a stethoscope?

Holly_1007

BLuvsE:

Can you hear it with a stethoscope?

I'm sure I would be able to by the time I delivered- great idea.  just have to find a stethoscope....

I'm not even sure I would like being poked and prodded, was mostly curious how other mothers who labor at home for a while ensure themselves that the baby is tolerating labor okay..

RockyMtnMama

holly71087:

BLuvsE:

Can you hear it with a stethoscope?

I'm sure I would be able to by the time I delivered- great idea.  just have to find a stethoscope....

I'm not even sure I would like being poked and prodded, was mostly curious how other mothers who labor at home for a while ensure themselves that the baby is tolerating labor okay..

The first time I was monitored on-and-off for my 18+ hours in the hospital.  The second time we stayed home for about 5 hours of my 6 hour labor and then went in and the baby was only really monitored with a doppler for about 5 min.  I didn't need that reassurance b/c I was comfortable with the process and wasn't worried about monitoring for decels.  Honestly decelerations are expected during your contractions - the baby is stressed during labor and so their heartbeat will slow and speed up depending on where in the contraction cycle you are at.

There are positions to encourage good circulation and oxygen flow to the baby - staying off your back (standing is always good or changing positions), breathing well (good source of oxygen for you and baby), laying on your left side, etc.   

Here is some info from two online sources that might help explain that decelerations are expected to some degree during labor, but also that the increased monitoring hasn't had huge impact decreasing baby deaths in the US and especially in low-risk (i.e. low intervention) labors/deliveries.  It might help you with reassurance that it's okay to not be monitored until you arrive at the hospital. 

(Sources: https://www.tree.com/health/pregnancy-information-childbirth-fetal-heart-monitor.aspx and https://www.healthofchildren.com/E-F/Electronic-Fetal-Monitoring.html)

Heart Rate Results

Heart rate monitors display three fetal heartbeat variations during labor and delivery. The fetus may have an early deceleration (slowing of the heart rate), a variable deceleration or a late deceleration:

• Early Deceleration: Fetal heart rate slows and quickens in time with labor contractions. Early deceleration results are not a cause for alarm: The fetus is responding properly to labor and delivery.
• Variable Deceleration: The fetal heart rate fluctuates at random. Random fluctuations of the heart rate while giving birth may indicate the umbilical cord has become compressed, and the fetus is receiving insufficient oxygen.
• Late Deceleration: The fetal heart rate cycle begins during labor contractions instead of at the beginning of the contraction, and is slow to return to a baseline rate. This may indicate the fetus is experiencing circulation difficulties.

In addition to monitoring the fetus' heart rate, the internal fetal monitor can be used to collect a small blood sample from the fetus. The blood sample is used to determine the fetus' blood pH, and can also show how much oxygen is in the baby's bloodstream.

Responding to Fetal Distress

Immediate medical attention is required if the fetal heart rate is outside the normal range. Treatment includes administering oxygen to the mother to increase oxygen to the fetus, increasing the mother's fluid intake and changing the mother's physical position. If these strategies fail to return the fetal heart rate to normal, an emergency C-section will be considered.

Risks

Besides the risk of an unnecessary cesarean section , other risks posed to the mother by EFM include her immobilization in bed. Immobilization simultaneously limits changing positions for comfort and causes changes in blood circulation, which decreases the oxygen supply to the fetus and can lead to abnormal changes in the FHR on the EFM that was applied to detect these changes. Another problem with the use of the EFM is that practitioners have a tendency to focus on it instead of the laboring woman. For these and other reasons, the United States Preventive Services Task Force states that there is some evidence that using EFM on low-risk women in labor might not be indicated. EFM, however, has become an accepted standard of care in many settings in the United States for management of labor. Interestingly, there has not been a reported reduction in perinatal morbidity in the United States with the use of EFM. There is a benefit to using EFM in women with complicated labors, such as those induced or augmented with oxytocin, prolonged labors, vaginal birth after having a cesarean section, abnormal presentation, and twin pregnancy.

 

StefandTodd

I could feel him moving all around the entire labor...I felt totally confident he was fine, and highly annoyed by the constant monitoring they did once I got to the hospital (dilated to 8 at that point).

tokenhoser

I laboured at home (and at garage sales and at church) for about 10 hours. I just didn't feel any worry for the baby. I'm not a worrier and I never thought once "I wish I had a monitor".

I'm also the kind of mom that thinks Angelcare monitors are ridiculous, though. People have different risk thresholds. I did not consider labouring at home to be risky (especially since my water didn't break until I was fully dilated and at the hospital).