Trace when in labour

[NewYearsEveEve]

Watching One Born Every Minute and curious... if you are admitted to a labour ward, are you automatically put onto a fetal trace when in labour? Or only if high risk or complications? I think I'd be reassured to know that there's an indicator if the baby is in trouble

I was, to get a base heart rate, and I was low risk / first baby. I had a lively baby though and it took 2.5hours to get a base rate (each time just for “20 minutes more”): for my second they now have wireless monitoring so I’m hopeful I can stay much more mobile through it.

I was under the impression it wasn't usual; they just listen in with the Doppler at certain intervals. I had a trace with my induction though.

I believe the guidelines say that if you request one they should allow you to have a trace though. Whether or not that's true in practice though...

I was supposed to because I was overdue, but didn't want it because I wanted to stay mobile. The midwife said do half an hour and if it's all ok I'll take it off and do 15 min monitoring, which is what happened. I had to have it back on later when I had the drip and epidural though.

NICE guidelines says CFM is best practice for VBAC, but it is not required under normal circumstances.
Monitoring guidelines are not definitive.
I’m 9 years into a medical negligence claim which hinges on lack of foetal monitoring.
Different trusts will have different equipment available. Different numbers of women in labour at any one time. Equipment is out of order.
Intermittent aural auscultation is fine if conducted at regular intervals in low risk labour.

My midwife told me that usually they monitor every 15 mins but as I had a c section previously I will have to be monitored continuously. This will be wireless though so I can still be active and have a water birth if I wish.

The midwife said do half an hour and if it's all ok I'll take it off and do 15 min monitoring, which is what happened.

I was overdue and induced (community midwife told me I was nowhere near going into labour after 3 days of contractions. 1 hour later in hospital I was 2cm dilated and contracting. . They induced me anyway.

DD always hated the little Doppler, so the proper trace freaked her out and she kept moving away. I was using a TENS and loving it. They insisted on a 20 min trace, which meant going back to 0 on the TENS. Took nearly 2 hours to get that 20 minutes trace and I was climbing the fucking walls.

If everything is straightforward then you shouldn't be given continuous monitoring. Things like being induced, high blood pressure or having an epidural would change that. Getting a baseline with a CTG trace if everything is normal shouldn't be standard practice unless they have concerns. If you want continuous monitoring, though, you're entitled to have it. It stops you being as mobile and can increase the likelihood of unnecessary intervention but if you'd prefer and it'd reassure you then it's a very reasonable request.

Low risk labourers will follow the pathway of intermittent auscultation which is listening to the heart rate every 15minsnfor 60secs in 1st stage of labour and every 5mins in 2nd stage.
The findings in the most recent Cochrane review was...

CTG during labour is associated with reduced rates of neonatal seizures, but no clear differences in cerebral palsy, infant mortality or other standard measures of neonatal wellbeing. However, continuous CTG was associated with an increase in caesarean sections and instrumental vaginal births. The challenge is how best to convey these results to women to enable them to make an informed decision without compromising the normality of labour.

High risk women will be offered and recommended CTg in scenarios such as prev CS, fetal anomalies, medical problems such as diabetes, small for gestational age,prolonged rupture of membranes etc

The only thing I will add is to have your birth partner keep a check on how often monitoring is done if intermittent. I had a previous CS and so should have had CFM. The equipment didn’t seem to be working, so they opted for intermittent auscultation. Unfortunately, the student me did not carry out sufficient monitoring (at one point 45 minutes with no attempt) and was having difficulty locating FHR (to the extent that we don’t actually trust the readings she recorded when challenged).
Hindsight is a wonderful thing.

stripeyfish how do the monitor you wirelessly?
I desperately don't want to be monitored again this time. My last labour I felt like I was strapped to the bed with all the wires and tubes (oxytocin induction+ trace monitoring+ blood pressure cuff +BP finger monitor).

I'd love a water birth but not sure you can if it's a VBAC?

I’ll be honest I have no idea how they do it wirelessly, didn’t ask just took the midwife’s word for it. She just said when I phone Labour Ward to tell them I’m going in to ask them to make sure there’s one charged up to use.
The midwife and consultant have both said no problem to a water birth for my VBAC assuming things are going well, don’t know if that varies from trust to trust though?

Recommendation for VBAC is continuous monitoring. Obviously you can make an informed decision on that. Some units have wireless monitoring and some of that is waterproof.

It’s all very trust dependent.
I had a prev Cs and going for VBAC. My unit amhave just got an inflatable pool for delivery suite which I may use if the waterproof monitoring is available

Thank you all, some really useful info here