External fetal monitoring measures the strength of a contraction as well as the speed of a heartbeat. It does not measure the quality of a heartbeat, which is better heard with a fetoscope and human discernment of what the sounds mean. Therefore, a machine can many times indicate distress that might not really be distress. Or it might not show it while indeed there is a weakening of the strength of the heartbeat.
This technology is useful for times in a hospital when there can’t be continuous care, and there is a record this way of what is happening to mother and baby. ACOG, however, doesn’t recommend routine use of it to take place of care where the attendant takes notice of the nuances and changes in what was considered standard. Doing so would therefore diagnose a problem earlier. The false positives also usually result in a spiral of further interventions. Most of the time these are not necessary and are more of an indication on machine failure than fetal failure. If you do not wish further intervention unless absolutely necessary, it’s worth it to wait it out and ask for a second opinion and/or be listened to via a fetoscope. The EFM also inhibits movement which can help with labor and delivery.
Times where EFM is indicated include induction or augmentation of labor since this can easily cause fetal distress, fetoscope showing too fast or slow heartbeat as the EFM can track the speed for a certain amount of time, breech position and other rare scenarios in childbirth that are allowed a trial of labor.

Leave a Reply