What is Intermountain's policy on intermittent fetal monitoring during labor? скачать в хорошем качестве

What is Intermountain's policy on intermittent fetal monitoring during labor?

You asked a question about Intermountain Healthcare's policies on intermittent fetal monitoring during labor, and you're wondering, basically, what is our stance on it. Intermountain Healthcare believes in healthy moms and healthy babies. We want the best outcome possible, and we achieve this by following evidence-based medicine. And we strongly believe (those of us who work on Labor & Delivery - obstetricians, OB providers, and Labor & Delivery nurses) that fetal monitoring improves a baby's outcome. And really, what it comes down to is that the best indication we have that your baby is doing well while inside of you is that the pattern of their heart rate is showing us that they have enough oxygen while inside of you. So we go to extensive training and learn how to interpret the baby's heart rate pattern. And different patterns mean different things. And we do expect babies to experience different types of stress during labor. There might be a pattern showing us that the umbilical cord is being pinched. There's another type of pattern that shows us that there's not great blood-flow going through the placenta for one reason or another. There's another type of pattern that shows us that the baby's head is being squished towards the end of labor, and that happens - that's not a deprivation in oxygen, that's just something that's associated with labor. Even when we're seeing signs of stress, we look at the entire picture. Are we seeing reassuring signs too? So really, what it comes down to is if your baby isn't being monitored, we don't know these things. We don't have this information. If we're monitoring you and your baby and we see signs of stress, then we can intervene and support your baby through labor. If we're not monitoring your baby, then we don't know that we need to react to certain types of stress that they might be experiencing, and that's when compromise can occur. So a lot of women say, "Oh, my worst fear is that I might need an emergency C-section or something." But sometimes it does come down to that after all of our interventions. If the baby is not responding to all of the things we're doing to support them while inside of you and to resuscitate them in utero, them sometimes our only option is a C-section to make sure that the baby is as healthy as possible. And again, we wouldn't know that that needed to be done if we weren't watching. I had been a Labor & Delivery nurse for a few years before I had my first baby, and I've since had another, and I've been a Labor & Delivery nurse for a total of 10 years, and with everything I know, I wouldn't be comfortable being in labor and being off the monitor. And so there is no policy saying that there always has to be continuous monitoring unless certain circumstances exist. If you are on pitocin, you have to be on continuous monitoring. But if you are a low-risk pregnancy and you don't have any of the circumstances going on that necessitate continuous monitoring, your doctor might let you do intermittent monitoring where you're on the monitor for a certain amount of time, and then you're off, and then we put you back on, and then you're off. And sometimes this can work. But really, I think we can blend both worlds, because say you want to labor in the tub. Most of our hospitals have telemetry units that are waterproof. So you can get in the tub, you can still be unmedicated, and get in all the positions that you want to be in, and even be in the tub if your water is not broken while being monitored. That is possible to blend the two worlds. And that's what I love about a hospital environment, because you have the safety net a hospital provides, and we can also help you have the type of experience that you want to have during labor. I recommend talking to your OB provider at your next prenatal appointment about their feelings on continuous and intermittent fetal monitoring. And based on their knowledge of your situation and their experience, they'll be able to give you their thoughts on the matter. If you have any other questions for me in the future, feel free to ask them on our Facebook page at   / intermountainmoms  , and recommend us to your friends and family too.