When Can I Expect Internal Monitoring During Labor?
You may be expecting to be monitored during your labor at the hospital, but what you may not be expecting is the use of internal monitors. Unlike the external monitors that are commonly used during labor—the straps that go around your belly—internal monitors are, well, just that—inside of you. After your water has broken, your nurse or other care provider may place two different kinds of internal monitors inside of you during your labor: one to monitor your contractions and one to measure the baby’s heart rate.
There are many different types of internal monitors out there, and the use will vary from facility to facility, but in general, the monitors are: Intra-Uterine Pressure Catheter (IUPC), which will measure your contractions and a Fetal-Scalp Electrode (FECG), which will measure your baby’s heart rate.
An IUPC is a long, catheter-like tube that is placed inside the uterus and floats next to the baby. It measures the pressure in the amniotic fluid during a contraction and provides an extremely accurate measurement. A FECG actually adheres to the baby’s scalp with a very, very tiny screw-like monitor. Both monitors can be placed in a matter of minutes and are not painful; you will simply be placed back in a reclined position, much like a vaginal exam, and the monitors will be inserted through your cervix.
In general, health care providers try to avoid the use of internal monitors, as it can restrict movement during labor and be a source of exposure for infection, but sometimes, their use is warranted during labor for reasons including:
- Size: Sometimes, the size of a woman’s belly can make it hard to accurately measure contractions with the use of an external contraction monitor. A large stomach or extra weight may also interfere with the ability for an external monitor to accurately pick up the baby’s heartbeat.
- Position: If you find that you are lying on your side a lot during labor, your nurse may need to place an internal monitor, as the side-lying position can cause contractions to appear distorted with an external monitor.
- Pitocin: Many women who are having labor induced or augmented with Pitocin will need an internal monitor to ensure that their contractions are coming too frequently or intensely. Because external contraction monitors can only measure the frequency of contractions and not the intensity, internal monitors can provide an accurate measurement of how intense your contractions really are.
- Fetal Heart rate: If there is any question if the external monitor is accurately picking up the baby’s heart rate, or if the baby’s heart rate shows signs of distress, an internal monitor might be placed.
If your care provider mentions the use of internal monitors, you can be prepared with some pre-knowledge here, but as always, don’t be afraid to ask questions about your care!