Internal Fetal Monitoring – Stop the Fearmongering!

There’s a post that has been passed around Facebook this week. It’s a post that shows an up-close picture of an electronic fetal scalp electrode. Aka, an internal fetal monitor. 

See below.

Birth professionals all across Facebook have been sharing this meme. Most of them to support a natural birth/all intervention is evil perspective. But we’re not down for that here at Tucson Doulas.  We believe in honesty and accountability.

So let’s have a chat about internal monitoring.

Internal monitoring is a method of monitoring a baby from the inside. It’s also a more accurate method of monitoring the beat-to-beat variability of the baby’s heart rate during labor.

Even though it’s more accurate than external monitoring, it’s not an intervention that is used routinely in our community. For most labors, external monitoring will be all that is needed.

However, some situations warrant closer monitoring of the baby. Internal fetal monitoring with a fetal scalp electrode can be beneficial in these cases. As a result, we’ve seen this type of monitoring help clients to avoid cesarean birth.

So let’s talk about how the internal fetal monitor is applied.

The electrode is packaged threaded through a skinny tube about the diameter of a drinking straw. One of those chubbier straws, like Mcdonald’s or Jack in the Box, uses. This tube allows the electrode to be guided into the vagina and through the cervix to the baby’s head.

A thin wire shaped like a spiral is at the end of the electrode. This wire is applied to the baby’s scalp with a twisting motion. This motion threads the electrode into the top layer of the baby’s scalp. The meme asserts that this puncture of the baby’s skin hurts the baby. The truth is, we have no way of knowing if it actually hurts or not. It punctures the skin, and the electrode will stay attached until just before birth. It might hurt, it might not.

I’ve heard it explained this way. Let’s look back on our childhood.

Did you ever thread a safety pin under the top layer of your skin on your fingers? In some cases, it may be like that. Without pain. In other cases, it may hurt.

I’ve seen babies born with a fetal scalp electrode, and you can’t tell where it was inserted. On the other hand, I’ve seen babies who had a mark where the electrode was placed after birth. There’s no way to predict which outcome a baby will have.

Let’s take a look at a real-life comparison of the electrode against known measurements.

The width or gauge of the wire on the electrode is less than 20g. This means it’s smaller than the post of your average earring.

The circumference of the actual spiral of wire that threads into the skin is 4g or 7/32 of an inch.

As opposed to the image posted above, where the photo is blown up, there is no comparison point. You can see the diameter is actually quite small. The electrode is very thin.

As with all interventions in labor and birth, there is a time and a place for them. You also have the right to ask questions about why this procedure is recommended. You can also decline any intervention or procedure you are uncomfortable with.

Here at Tucson Doulas, we recommend that you use your B.R.A.I.N. When you would like to be informed of any procedure or intervention remember to ask:

What are the: Benefits, Risks, Alternatives, check your Intuition, and ask what happens if you do Nothing.

Please don’t buy into the fear-mongering that is running rampant in Facebook groups due to the first image. If you have concerns about this intervention, contact your doula team today.