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

Women at high risk, and those women with an existing condition such as diabetes or having a Rhesus negative blood group, are carefully monitored so that the baby’s welfare is never in jeopardy.

You will attend an antenatal clinic at either the hospital where you will have your baby or at your doctor’s surgery. Most of the women attend once a month or so up until 7 months of pregnancy, every two weeks up to 9 months of pregnancy, and then once a week for the last month.

You will need to attend mo/e frequently if any complications develop, such as your expecting more than one baby, if you have a pre-existing medical condition, or if you are at risk.

Attending an antenatal clinic in a hospital can be intimidating and frustrating: there may be a large number of staff coming and going, and you may be kept waiting for some time. Many women describe it as a cattle market. Negative feelings can be made much worse by the discontinuity of care — it’s quite possible to see different nurses and doctors at every visit. Much of this can be avoided if you opt for shared care, a GP unit, or the “domino” system where you mainly see your doctor or your midwife for check-ups, with occasional visits to the hospital antenatal clinic.

When you go, try to make the best of your time at the antenatal clinic by taking along something to read or to do, and some food and drink just in case the food trolley doesn’t come by while you are there. Take a friend or your partner with you for company and moral support.

Ideally, your partner should attend at least one antenatal clinic with you so that he is familiar with what you go through and can sympathize. He can also have his questions answered and, most importantly, give you moral support. If you already have young children, arrange for them to be looked after if at all possible because they can be quite a handful in a confined space with little to interest them.

On your first visit to the antenatal clinic, you will be asked various questions on the following subjects:

- Your personal details and circumstances including age, marital status, next of kin and religion.

- Childhood illnesses or serious illnesses you have had.

- Serious illnesses that run in your family or in your partners family

- Whether there are twins in your family

- What symptoms of pregnancy you have, and the state of your general health.

- Details of previous births, pregnancies or problems in conceiving.

- Whether you are taking any prescription medication or whether you suffer from any allergies.

- your menstrual history — when you started, how long your average cycle is, how many days you bleed, and the date of your last menstrual period (IMP).

- From the above information, your estimated delivery date (EDD) will be calculated.