How intermittent is intermittent monitoring?

[feedmenow]

Hopefully just a quickie here.

I am planning a vba2c in March and the hospital have said I need CFM. However, I want intermittent monitoring.

But I have no idea how intermittent monitoring is! I feel this is something I need to know because I'd feel rather silly demanding something that I don't really know all that much about!

So how often do they monitor and for how long at a time?

With my first I was monitored twice in just over 12 hours, first time as the contractions started (I was induced) I was supposed to be on it for 20 mins, 2 hours later I had to take it off else I was going to wet myself. And then once more when they moved me down to delivery, not sure how long for though, I was well away with the fairies by then.

With my second (induced again) spent about 45 mins on the monitor before I told them to take it off and I wasn't having it back on again I didn't have it back on.

In Sheffield 2 years ago it was every 15 min during active labour, taking my blood pressure and listening to baby's heart each time, with internal exams at least every 4 hours.

I think they do something different during the pushing bit - but I was on an epidural by then so couldn't tell you for sure.

I had my 2nd VBAC last may - I REFUSED CFM. Mainly because the risk of ending up stuck on the bed was too great.

They listened in with a hand held doppler about once an hour and it was fabulous as I could be in a any position I wanted.

Thanks for the replies!

Farcica, that is exactly my worry. So when they listened in, was it just for as long as they listen at, say, a routine midwife appt? Long enough to hear a clear, strong heartbeat and then that is it? Did you tell them before you went in that you wouldn't have the CFM or did you wait til you were actually there?

They have tried to tell me I'll still be able to be mobile with the monitor on but I don't really think I believe a word of it [sceptical]

When I was monitored with ds2 it was every 30 min for 15 min.

feedmenow - I had a homebirth but did go into hospital briefly to be checked over. I was hooked up to the machine for about 20 mins and wasn't on the bed - sat on ball or stood. TBH I know they say that you can be mobile, but I felt like I had to stay fairly still so that the pads didn't slip out of place. There is also a limit to how far you could move due to the cables I would think.

When back at home mws just used a hand-held doppler. I think at the pushing stage they used it after each contraction, less earlier on.

Hope this is relevant...

there are protocols re monitoring with a doppler before , during and after a contraction during labour...cannot find them at the mo...but it is intermittent, and then at the second stage it is a bit more frequent IIRC.

i should htink they are in the NICE intrapartum care guidelines, will try to look them up later on

In my experience in the UK, it was a quick listen in on every second contraction.

with ds1 2 years ago, intermittent = whenever a midwife was free of other work and remembered i was supposed to be having it.

not based on clinical need or research.

feedmenow

I told them when I arrived at the hospital (had it in big clear letters in my birth plan - which was stapled to the front of my maternity notes ) that I wasn't having CFM.

Listening in was probably slightly longer than when you visit the midwife - but as it was just a hand held doppler I hardly noticed. Think they took my blood pressure occasionally too?? (can't remember exactly LOL).

They listened in approx once an hour - and a couple of times during pushing.

I was "reminded" of the risks by several people. Firstly the lovely MW who saw me when I got in, and subsequently delivered DS3 a few hours later - she'd read my notes - and obviously realised that I wasn't going to be swayed. So came in, gave the "risks" talk and when I told her I still didn't want CFM she told me "I thought you'd say that so didn't bring the machine with me" .

A little while later I had the senior MW (or somebody or other) come in and give me the talk, she also wanted to put a cannula in - told her to forget both of them. She tried to lecture me on why I should have the cannula (she gave up on the CFM part of if straight away as I made it very clear that I'd had the "risk" talk and wasn't interested). "If you need an EMCS then it's one less thing to do" blah blah blah. Told her that if I needed a EMCS they could sort it out then - as I was sure it wouldn't take long. She really didn't seem to have much faith in me (especially given my birth/labour history) doing it on my own.

Then while I was really screaming the place down I have vague recollections of the registrar coming in and giving me the speel too (although I was so far gone that as soon as I realised who she was I switched off, then when she'd finally finished (about 10 contractions later - as my contactions were so close together LOL) I told her to sod off.

DS3 arrived about 1hr after that and I mentally stuck two fingers up at the senior MW as she was the one that gave me the few stiches I needed afterwards (with the lovely MW sat behind her winking at me) LOL

the protocol for the trust i work wihtin in every 15 minutes for approx one minute or throughout a contraction if one occurs whilst listening in, once labour is established, then once you get the second stage (pushing) it shoudl be with every contraction.

this is done with a handheld doppler. so like used at your midwife appointemtn at home or at the surgery.