When Can I Expect Internal Monitoring During Labor?

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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!

 
Credit: Flickr/koadmunkee

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When Can I Expect Internal Monitoring During Labor?

Chaunie Brusie is a writer, mom of four, and founder of The Stay Strong Mom, a community + gift box service for moms after loss. ... More

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5 comments

  1. Melissa says:

    I was induced with Pitocin and had 2 doses of cytotec prior to placement of the IUPC. It was extremely painful because the cytotec makes all the tissue extremely raw. As soon as I got up to use the bathroom after it was placed, it fell out. I had it placed again and it fell out. Third time’s a charm right? Nope, fell out again. I finally got an epidural and had a different doctor try and since I couldn’t get up, it stayed in but it didn’t pick up any of the contractions I was having. After all that, my labor still failed to progress and I ended up having a c-section.

  2. Nicole says:

    I had the scalp monitor. My son kept moving arund and after a while the external monitor wasn’t picking up his heart beat. It scared the hell out of me, but everything turned out fine.

  3. Jaime says:

    The doctors used the scalp monitor on my daughter during my first pregnancy. I had pre-eclampsia and my blood pressure went through the roof during labor. It caused my daughters heart rate to drop during the contractions so they wanted an accurate reading to make sure she wasn’t in too much distress. It was like the monitor wasn’t even there; I didn’t feel it and my daughter had no marks on her when she was born.

  4. Kit says:

    I had the scalp monitor on me. Mommy was in labor for 48 hours, trying to hold out against the inevitable C-section. With gestational diabetes resulting in a 10.5 lb baby, there was no way she could escape the C-section. However, I have heard that some moms with a history of gestational diabetes will induce their own labor about three weeks early, so the baby can be born at a normal weight of 8 lbs or so, because in that last month the baby really packs on the weight and a giant baby isn’t going to be born naturally.

  5. I have never heard of these! Good to know before I get there…

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