Continuous EFM

Continuous Electronic Fetal Monitoring (EFM)

What to Know about EFM

  • Routine continuous Electronic Fetal Monitoring (EFM) provides no benefit for babies and increases the risk of instrumental (e.g. use of forceps) vaginal births and cesarean deliveries.
  • The American College of Obstetricians and Gynecologists (ACOG) recommends that for healthy, low-risk births  (most births), fetal heart rate be monitored with a fetoscope or Doppler stethoscope every 30 minutes in active labor and every 15 minutes during pushing.
  • The World Health 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 sped 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 Continuous EFM

  • 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 Safe and Healthy as Possible if You Need Continuous 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.

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