Continuous EFM

Continuous Electronic Fetal Monitoring

From The Official Lamaze Guide: Giving Birth with Confidence.

What to Know:

• Routine continuous EFM provides no benefit for babies and increases the risk of 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’ll 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 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.

Read more about medical interventions:

• Induction by artificial rupture of membranes
• Induction with pitocin
• IV fluids
• Epidural and anesthesia
• Movement restrictions
• Directed pushing
• Episiotomy
• Cesarean surgery