Routine continuous EFM provides no benefit for babies and increases the risk of instrumental (e.g., use of forceps) vaginal deliveries and cesarean for mothers.
The American College of Obstetricians and Gynecologists (ACOG) recommends that for healthy, low-risk women (almost all women), fetal heart rate be monitored with a fetoscope or Doppler every 30 minutes in active labor and every 15 minutes during pushing.
The World Heath Organization (WHO) encourages intermittent manual listening and warns that EFM is often used inappropriately.
You May Need Continuous EFM if:
Your labor is induced or speeded up with Pitocin.
You have an epidural.
Your baby’s heart rate changes.
You or your baby has a health problem.
How to Avoid Unnecessary Use:
Remember that routine use of continuous EFM doesn’t make labor safer for your baby.
Find a caregiver who doesn’t use continuous EFM routinely.
Talk to your caregiver about intermittent fetal monitoring.
Stay at home as long as possible in labor.
How to Keep Labor as Normal as Possible if You Need EFM:
Remember that your body knows how to protect your baby during labor.
Continue to move as much as possible, both in and out of bed.
Ask staff to turn off the monitor’s sound.
Ask staff to turn the monitor away from you and your helpers so it doesn’t distract you.
Ask for a telemetry monitor (that is, one that's not attached by wires to the machine).
Ask to be disconnected from the monitor for regular trips to the toilet.
Remind your helpers that you are the one in labor, not the machine.
It’s a day you’ll mark with cake and candles in the coming years—the day that you finally get to meet your new baby! You’ve waited many months for this moment, and spent considerable time thinking about how it will unfold.