What it is

There are two kinds of electronic monitors, external and internal. An external monitor can be used early in labour and is sometimes used during pregnancy to check the baby’s well-being. The internal monitor is slightly more accurate. You will have belts strapped around your body and a tiny electrode will be clipped on to the baby’s head. Your contractions and the baby’s heartbeat are recorded on a printout (partogram). There is also a video screen that records the contractions and heartbeats as visible waves, punctuated by flashing lights.

During a contraction blood flow to the placenta is reduced for a few seconds, and your baby`s heart rate will dip. This is quite normal and the heart rate returns to baseline when the contraction passes. If the return to base­line is delayed, your baby may be distressed and action can be taken early to protect his well-being. The latest type of EFM, known as telemetry, uses radio waves and allows you to walk around because the baby’s monitor is attached to a transmitter strapped to your thigh. The older equipment confines you to a bed or chair.

How it is done

Your waters bag are broken when the cervix is about 5-6 cm {2-TA in) dilated and the electrode is applied to your baby’s head. In addition to the baby’s monitor, which picks up his heartbeat, a second monitor is placed between your baby and the uterine wall to measure the pressure and contractions

Certain procedures historically associated with childbirth are being re-evaluated. Some have been found to be unnecessary, others unjustified. However, most of today`s obstetricians believe that they can guarantee that childbirth is a safer and happier experience for a mother and her baby with the help of modern technology.

By drawing your attention to the arguments con­cerning some standard medical practices, this will help you to question them assertively with your medical and nursing attendants. More often than not, your wishes will be complied with, especially if you have written a birth plan in advance, but occasionally you will be told that to continue with a particular option will put you or your baby at serious risk — for instance, if your baby is showing signs of distress and you fight to continue with a totally natural childbirth. Be prepared to adapt your ideas.

Shaving

Nowadays, shaving is unnecessary unless you are having a Caesarean section. Any chance of infection can be eliminated by wiping the vulva with gauze and simply spraying with an antiseptic.

Nil by mouth

Many modern obstetric units have aban­doned the old custom of nil by mouth but some hospitals may still practice it. There is no medical nor scientific rationale for starving a woman during labour. In fact, quite the opposite: the hard work of labour uses up much energy, which causes sweating, and a woman must replace the fluids that she has lost.

Before epidurals became commonplace for Caesarean sections, if a general anaesthetic became necessary it could not be given to a woman who had eaten recently as she might have inhaled vomit. But, even so, there is no reason why every woman should still suffer simply because a small number need surgical intervention.

Moving to a delivery room

In some hospitals a woman still has to undergo the physical and emotional upheaval of leaving the room in which she had so far laboured in order to have her baby in a delivery room. Ideally, labour should proceed smoothly in peaceful surroundings, and as long as a room is equipped with good lighting, oxygen in some form, and a suction apparatus to clear out the babys air passages, if necessary, I can see no reason why a woman in normal labour should be forced to move to a delivery room. Many progressive hospitals now have more congenial all-in-one labour and birthing rooms and, if possible, you should choose a hospital with these.

Induction

Starting off labour artificially is not a new idea, but it only became an easy procedure in the latter half of the twentieth century. Labour is usually induced for medical reasons such as pre-eclampsia, high blood pressure or post-maturity, when induction can save the lives of mothers and babies.

An induced labour may involve the use of a Syntocinon drip, which will restrict your movements. Such a labour can be shorter and sharper and probably will increase your need for heavy-duty painkillers.

Amniotomy

This is when the membranes (the bag of waters) surrounding the baby are artificially ruptured. It may be carried out in a high-tech birth, and if so, is usually done early in labour for three reasons. The first is so that electronic fetal monitoring equipment can be set in place; the second is to check if the amniotic fluid contains meconium (this is the baby’s first bowel movement and its presence may indicate fetal distress); the third is that once they are ruptured, the baby’s head can press down hard on the cervix, helping dilatation of the cervix and speeding up the first stage.