Does extra monitoring mean I can't have a water birth?

[Graciescotland]

I'm currently 37+5 weeks. We had a bit of a scare two weeks ago when my liver function tests (alt) came back abnormal. The hospital ran a battery of tests for pretty much everything including hepatitis, viruses, bile acids everything came back normal. Liver ultrasound and my Growth scan was normal too.

As they don't know what's wrong (it could just be a pregnancy hormone thing). They're going to monitor bump and I closely at the day assessment unit and keep checking my blood for any changes.

Obviously I want baby's safety to come first. I was just wondering what effect this has on my birth plan. Anyone experienced anything similar and been allowed to have a water birth? Or does extra monitoring at this stage pretty much guarantee I'll need electronic fetal monitoring. I will ask at hospital on Tues (next appointment) but I'd be grateful for any info in the meantime.

Different hospitals have different policies but where I was if you had anything slightly out of the ordinary you were on constant monitoring throughout labour and that meant no water birth.

Thanks for replying. I thought that might be the case. Can I ask whether you were supposed to go in quite early on in labour or were you still supposed to wait until contractions were five minutes apart?

Check with your hospital but if you are required to have continuous monitoring some hospitals have telemetry which means the monitors are wireless and waterproof. I'd like a water birth too and I'm lucky my hospital has these monitors so they are fine about it (I'm classed as high risk).

But it depends on your hospital though.

Hi Graciescotland

It would be worth probing a bit to find out why they think continuous monitoring would be better for you than intermittent monitoring with a hand held monitor (which they use if you are in the pool).

Ask them to tell you what the specific risks are if you don't, the benefits of having continuous monitoring in your case, what alternatives are there and what would be the risks of having intermittent monitoring. Ask for detail rather than generalisations and whether they have statistics they can show you.

It may be that for your very specific case continuous monitoring is the best option, or you may just feel safer that way.

But it's also worth taking on board that statistically there aren't actually better outcomes for mothers and babies who have constant monitoring - the only difference (statistically) is that the rate of instrumental and caesarean deliveries goes up.

Again, in your specific case this may be different, but there can be a tendency to say 'this lady has some symptoms we can't work out so let's monitor her all the time just in case', which can throw your water birth or desire to keep mobile out of the window.

It's all about balancing risks (and of course water births and births where you are mobile do tend to be faster and easier with less interventions so for some people less risks) so if you feel after talking through in detail you don't want constant monitoring you don't have to have it.

It's your birth and your body and while you should listen very carefully to all the risks and benefits of the various options the choice is yours.

Well the thing is there's nothing really wrong with me or if there is we don't know what. I think they're most concerned that my bile acids may shoot up or that I'll develop pre-eclampsia.

Equally there's every chance that I'll have a perfectly normal birth and my lft's will go back to normal after baby. However obviously I don't want to take any chances.

I had a VBAC waterbirth with DS3 and CFM was advised by cosultant (therefore not surprisingly waterbirth was not). Consultant MW supported my choice for intermittenent montioring with handheld and it was done every 20 mins or so. Had lovely WB as a result.

VBAC with DS2 was not waterbirth and had CFM up to point they put the 'wire thingies' up me and stuck them to his head cos they were worried about his oxygen levels. Apparent when he came out that problem caused by his knotted cord (completely random). Anyway VBAC with DS2 and CFM was no way near as good as the waterbirth.

Completely agree with Rebeccad BTW about rate of sections with CFM - well proven.

I had c-section twins first time round, and now want a VBAC - midwife has said I can labour in the pool, but not deliver, haven't asked why yet, as only 21 weeks. Probably depends on area and facilities - they have the underwater telemetry.