how can i do active labour with fetal monitoring?

[chibi]

Does anyone know/can recommend books etc which show positions for active labour and birth that are not completely incompatible with continual fetal monitoring?

I am planning a VBAC and will be monitored throughout the labour. I am concerned that being immobile will slow things down and result in another section, which I would like to avoid.

tia

It is more important to be upright imo. Very easy to be monitored with the usual machine this way.

You could ask your hospital if they have a telemetry monitor available, which is wireless and means you can move away from the machine.

Yes, I would say to stay upright too. dd was induced, 13 hour labour of constant monitoring so confined to the bed. Ds was a 3.5 hour labour, stood up the whole time. No comparison really. If you get a good midwife whio is into active birth, all the better. With ds, I didn't even have internals, and only had some brief monitoring with a sonicaid between contractions. Is constant monitoring really necessary? If it wasn't an absolute need, I would ask for intermittent monitoring, but I don't know what the situation is with a VBAC. Or, you could ask for a waterbirth which would make it less intrusive also.

Could they let you sit on a birthing ball?

Even though there was nothing wrong with me, I had continous monitoring forced on me with my son. I found a reasonable way round it was to spend most of labour sitting on a bed pan. It took the pressure of my coylx and was a bit like an improvised birthing stool.

(I didn't know birthing balls existed 7 years ago)

If you have a spontenous start to labour then I suggest you leave it as long as possible before going to the hospital.

thanks - I like the idea of the birth ball - I have one left over from last time. Intermittent monitoring sounds interesting to.

I have an appointment with my consultant next month, hopefully she will be amenable to these ideas. The last time I spoke to her she was very pro 'lie there and let us do our thing' so I hope I can be convincing!

firstly you can decline their offer of CFM

and ask for telemetry if available as Daisy has pointed out

also, you can remain upright. you can sit on a birth ball and of course trips to the toilet mean you need unplugging from the monitor

you can raise the delivery bed up so you can rest your arms on it and rock and wiggle your hips

you can sit astride a chair to open the pelvis and aid descent

being upright will help assist.

if you get tired and you do want to sit down, use the birth ball and lean on your birthing partner

or have the bed with teh back upright so you are sat up rather than lying down

I kept standing up! There was no way I could have kept still.

At one point I was kneeling backwards on the bed and there was an extra MW holding the sensors on. I never even thought about it, just moved because I HAD to.

Chibi - had quite a long discussion with my mw about this recently as have had 2 cfm births (my DS had meconnium in water & DD induced due to RFM). Was feeling v.stressed that this may happen again and that would go down the same epidural, forceps, episiotomy route due to having to lay still to be monitored.

Lovely mw response was that if hospital wish to monitor continually, they have to find a way to do it & let you remain active. She bluntly told me that mw will try to make their own lives easier by getting you to lay still, but that it's your birth and if you dont want to, tell them 'no'. My sister was at apptmnt, and is also my birth partner, and mw told her to be assertive on my behalf if I was too stressed to do it. She also suggested I write in capitals at top of birth plan that this is what I want, so that my sis can refer to it if neccessary.

Hope this helps - good luck x

If the hospital are adamant that you "have" to have CFM, I'd ask them what research they are using that shows CFM improves outcomes for either mothers or babies - I bet they don't have any. If they can't come up with a compelling argument as to why its a Good Thing I'd refuse it. They can't forcibly tie the the monitor onto your belly and chain you to the bed afterall (at least not without being liable for some heavy legal action)

I declined CFM with DC3, the midwife had to stand/move around beside me holding a hand one (like they use in antenatal appts) to my stomach. She looked bloody uncomfortable but was very supportive about it.

With DC2 I previously managed to be upright with CFM with telemetry, but hated the feeling of the straps around me , and kept taking it all off. In the end they just let me, since I had cfm for prom and a 35 weeks old baby, not induction I guess...?

With DC1 I was induced and did as I was told with CFM and stayed on the bed; which was horribly painful and led to epidural followed by episiotomy and forceps. Stand your ground, and fingers crossed for a great midwife for you, makes all the difference.

p.s. Dont rely on your birthing plan for giving them info, repeat it to everyone in the room.

that's just it - I feel like which midwife i get is luck of the draw. I have no doubt that a supportive one would make the difference.

the last time, the midwife's first words to me were that I was breathing wrong. It was pretty much downhill from there. I am just dreading a situation where I am going to have to be fighting with a midwife while trying to labour.

I wish I could afford a doula.

I feel so disheartened at times I think, f-k it, I may as well have an elCS as I will probably end up having one anyway.

I've seen it mentioned elsewhere on this site that there are grants available towards having a doula - sorry I don't know anymore than that though.

It doesn't have to be a doula though - Do you have anyone massively supportive and experienced in childbirth who could be a birthing partner? After my dh was useless in standing up for my wishes during DC1's birth, I've had my mum as well. She's fab - tells the midwife off if they suggest something not on my birthplan, v emotionally supportive, and much more patient with me than dh. I discuss all my plans and wishes with her, so if something changes quickly she knows what I want and why, and what research/experience I've based it on, and will quote it at people!

There are some FAB midwives out there.

I was able to sit in a rocking chair with lots of pillows and found rocking through the contractions really helpful. When I got too tired to rock the chair myself the midwife gently pushed my knees backwars and forwards for me so that I still has that motion. I found this so comfortable and it enabled the monitoring whilst I was still upright. I don't think I would have had the energy for standing anyway.

Does your hospital have a consultant midwife/head of midwifery that will meet women in advance of labour? I am in similar position with cfm being recommended - comm mw has suggested I get appt with her to discuss birth plan and options for keeping as upright and active as poss etc - apparently she writes all this up in maternity notes for whichever mw sees you for actual delivery - might carry additional/more weight to a birth plan written yourself if latter goes against other medical advice in your notes (and give you more confidence in enforcing it).

My midwife was happy to monitor me on the birthing ball with both my DCs. It worked well for me.

I think Hedgiemum might be onto a really good idea - take in a 2nd supporter purely to be your advocate. They don't even need to be experienced in childbirth (although it could help) as long as they were willing to help you do some research, you trust them and they were totally comitted to fighting your corner while you were in labour.

Its also worth remembering that if you don't get on with the MW you're assigned you can ask for another one - you don't even have to give a reason (although "personality clash" neatly covers most events without really casting slurs )

I am a great believer in approaching childbirth as an Olympic sport , and visualising the process and successful outcome in my head beforehand, as a kind of rehearsal. That's not to say it's a totally fixed thing, but at least I have an idea what I might like to do.

So how about running through the 'performance', seeing yourself in your mind's eye getting upright, moving around, pleasing yourself as to position, etc, so when it comes to the big day it feels a bit more spontaneous and natural, and a bit less like you are waiting for permission to obey your instincts?

Just a thought, anyway.

I had to have fetal monitoring with my second child (after planning a home waterbirth!). I was able to move around, use the birthing ball etc etc. The monitor kept pinging off but midwife was happy for me to move around. Despite it not being the birth I planned it was absolutely the birth I wanted as I felt in control and relaxed throughout with an easy, intervention-free delivery.
Pregnancy yoga books will have good pictures of positions for active labour. I had this one
I can also highly recommend a hypnobirthing CD (or even a course if you can afford it) to get you as relaxed as possible in the run up to, and during the birth.