Internal Fetal Monitoring – Stop the Fearmongering!

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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 Douals.  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, there are some situations that warrant closer monitoring of the baby. In these cases, internal fetal monitoring with a fetal scalp electrode can be beneficial. We’ve even 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 McDonalds 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.

At the end of the electrode is a thin wire, shaped like a spiral. 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. Truth is, we have no way to know if it actually hurts or not. It’s a puncture of 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 take a safety pin and thread it 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 who have had a fetal scalp electrode and you can’t tell where it was inserted. On the other hand, I’ve seen babies after birth who had a mark where the electrode was placed. 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 and there is no point of comparison. 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 that you are not comfortable 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, Risk, Alternatives, check your Intuition, ask what happens if you do Nothing.

Please don’t buy into the fear mongering that is running rampant in Facebook groups as a result of the first image. If you have concerns about this intervention, reach out to your doula team today.

One Response

  1. Lil
    | Reply

    This was very helpful. I had this with my son, and didn’t know how it was attached. The FB post made me feel guilty, but this was pragmatic and reassuring. I had my baby vaginally, and all was well in the end.

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