Birth Question - Monitoring Heart Rate in 'Natural' Birth?

[AlexanderSalamander]

Hi, I guess I'm hoping for some expertise on a natural birth and how it is 'managed'.

I'm currently pregnant with my 2nd baby, due in June. I had a traumatic birth with my first, so this time I'm trying Hypnobirthing which I've just started.

I would love a water birth this time, or otherwise just a natural, drug-free birth in a midwife lead unit with no interventions or complications!

I'll cut a long story short, but for my first birth, I had an episiotomy due to my daughter's heart rate not returning back up to normal after each contraction/push. I was laid in a hospital bed and they attached a wire to her head. So the Dr cut me to get her out quicker. Not sure if this saved her life or what.

My husband and I recently had a difference of opinion here which got me thinking, as I believe it was more of a hospital policy to cut me to get her out quick, whereas he says he was watching the monitors and my baby retract back inside after each push, so I needed to be cut as she needed to come out quick. He believed the heart rate lowering pretty much meant that she was dying inside me.

I honestly don't mind that I was cut, I didn't even know until hours after and if it helped or saved my baby, then that's fine; I just feel that it was more of a "Doctor feeling the need to intervene" situation.

My question therefore is, if she hadn't had the wire attached, or I wasn't being monitored, as would be the case in a water birth or midwife lead birth, we wouldnt have known about her heart rate. So how is this monitored in normal circumstances, or, how do you go about with not having the heart rate monitored? What would happen? How would you or midwives know that the heart rate wasnt recovering and the baby needs to be born quickly?

[AssassinatedBeauty]

It sounds like you need a birth debrief for your first delivery, where a midwife goes through the hospital notes with you and explains what was happening. You can ask questions exactly like the ones you've posted here, and they can answer specifically about your individual situation.

[Isitmybathtimeyet]

You are monitored in a midwife-led birth, but not by machines. I only have home birth experience, which will be a bit different, but in that scenario they check the baby's heartbeat very regularly with a stethoscope and also after contractions, so pick up on problems quickly.

[AlexanderSalamander]

@assassinatedbeauty I did have a birth debrief 5 months after my first birth, but I didn't prepare well for it and the question of the episiotomy didnt come up then (I'd turned against the idea of any more births!). I guess I could ask my midwife at my next appointment in 6 weeks, but it was just on my mind now so was hoping for some insight

[EvilEdna1]

During the second stage of labour, the.midwife will listen to your baby's heartbeat after each contraction with a hand held Doppler. Any hint that there is a problem they will get you out of a birthing pool and into a room where they can set up continuous monitoring.

[Isitmybathtimeyet]

Doppler of course, not stethoscope. I couldn't think of the word.

[AlexanderSalamander]

@isitmybathtimeyet ah thank you! I didn't know that, I thought you were literally just left to get on. I think I'd like the home birth experience but in a midwife unit, just because I'm a bit squeamish about the clean up afterwards so don't want that at home! That's good to know, thank you.

[AlexanderSalamander]

@eviledna1 great, thank you too!

[DrWhy]

Policy at our MLU is for the midwife to listen every 15 minutes, not every contraction. I had a water birth with DS and they listened three times while I was in the pool - he was around 45 minutes to be born after getting in the water. In between we were left on our own but we were happy with this, not sure if we’d wanted someone to stay there would always be staff for that (there def would have been for me as I was the only lady on then4 bed MLU that evening!).
I definitely think a long chat with your midwife is needed, as someone suggested, a debrief from your last birth and also a discussion of your hospitals policy in different settings.

[littlemissalwaystired]

Guidelines state intermittent auscultation every 15 mins in first stage, and 5 mins in second stage (pushing etc). It's done straight after a contraction to detect any decels that may have occurred.

[DrWhy]

I suspect in my case they didn’t realise I was pushing until the third time they came in, the final stage went fairly quickly and they may have been doing more checking in that last 5-10 minutes when the 2nd midwife was there too.

[AlexanderSalamander]

Thanks all, its put my mind at ease now knowing that at least the checks are made when I thought you were just left to labour.
I'll definitely have a chat with my midwife next time to find out my hospital's policies so I know more!

[Mysterycat23]

Waterbirth here. About 2h in the pool. Heart beat was checked a few times with I guess a waterproof handheld device. I didn't get out of the pool. I wasn't aware of the midwife doing the checks but my OH was and told me afterwards when I complained to him they hadn't done any checks!

[snowone]

I had a MWL birth and am planning the same this time. She listened very regularly to the DD heart rate throughout the pushing stage. She let me push for 2.5 hours before saying they were going to have to intervene if I hadn't done it myself in the next half an hour......she was out within 15 mins. Good luck!!