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Electronic Fetal Monitoring (EFM) – What Is It?

Credit @mommy.labornurse on Instagram

Electronic Fetal Monitoring (EFM) is a method in which electronic instruments are used to record the heartbeat of the fetus and contractions of the mother’s uterus
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So, if you’re delivering at a hospital, you may need fetal monitoring (unless you come in quickly and blow a baby out!)⁣⁠
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You’ll have two external monitors attached to you (sometimes internal monitors are necessary for high-risk mamas), one to monitor contractions, and one for the baby’s heart rate.⁣⁠

Is Electronic Fetal Monitoring Safe?

⁣⁠Electronic fetal monitoring ensures your baby’s health and safety during labour and delivery by reassuring you and your practitioner that it’s safe to continue with labour and delivery, as long as a normal heartbeat is detected and there are no other problems

When the baby’s heart rate is monitored, medical staff are looking for red flags that might indicate distress and/or the potential need for intervention. Some babies do not cope well with the normal stress of labour so medical staff will look for things like accelerations in heart rate, decelerations in heart rate, or general variabilities that let them know something could be going on.⁣⁠
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Monitoring your contractions also gives staff important information about your labour progress because they can see frequency and duration. One thing they CAN’T tell is the strength of the contractions. ⁣⁠
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EFM is necessary in some cases and HAS saved lives. Unfortunately (like cervical exams), in some instances if it overused. The fact is, there is little research-based evidence that we need to monitor low-risk mamas as we do. ⁣⁠
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In fact, some research shows that continuous EFM actually leads to more interventions (such as unplanned C sections and use of forceps) which can lead to higher and higher mortalities.⁣⁠Although you can refuse to monitor entirely, the staff may be unhappy about this and ask you to sign a form or statement releasing them from liability if anything goes wrong during labour and birth.
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Current ACOG guidelines recommend intermittent fetal monitoring for low-risk pregnancies. Continuous EFM is only necessary for high-risk mamas. But every hospital has a different interpretation of what “intermittent” actually means…⁣⁠
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The bottom line – now you know what’s on that screen while you’re in labour! BUT it is recommended that you with your EFM provider before you’re due so that you know what to expect and can put preferences on your birth plan!!⁣⁠
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SO. EFM, we kinda need you, but we kinda hate you. You also make all the nurses go crazy 😜⁣⁠

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toni_hatinger
toni_hatinger
7 days ago

Thank you for this explantation! It’s nice to know that it’s not just some gadget, but an actually useful one that helps nurses help us better!

mrs.mussleman
mrs.mussleman
7 days ago

The monitors made me MISERABLE. My doctor switched to internal monitoring and it was SO much better. Will definitely be requesting internal monitoring the second time around.

laura_alohan
laura_alohan
7 days ago

I kept pulling the monitors off of me. They’re way uncomfortable while having contractions. I had one nurse tell me my baby would die without it. 🙄 It was just a scare tactic which is very unappreciated and inappropriate. I was laboring fine and my daughter was doing fine. Then it was shift change and I had a lovely nurse who held the monitors to my belly while I labored, so I didn’t have to have the uncomfortable bands wrapped around me.

tracysnilner
tracysnilner
7 days ago

When I was in the early stages of my (induced) labour, we noticed this screen, figured out what it did pretty quickly, but the contraction line was next to the abbreviation ‘TOCO’… And we didn’t know what that stood for. Still don’t. But it sounded like ‘taco’, and so for many hours, contractions were… Tacos! When a contraction came, I would tell my husband, “taco taco tacoooo!” until it passed. The nurses thought we were bananas. Then my water broke and everything got less hilarious, so no more tacos. But it was fun while it lasted 😁🌮🌮

susan_dawsen8323
susan_dawsen8323
7 days ago

Haha! Need some help , Can’t decide whether I want to put him in a kennel or lock him in the bathroom! Haha! xox

spectrumdoula
spectrumdoula
7 days ago

Thank you for this 👏

mpasqualexo
mpasqualexo
7 days ago

EFM saved my baby! I ended up with an emergency c section after his heart rate was non existent and he was in distress from my overlapping contractions. My epidural didn’t have time to work, so I was unfortunately put under, but I am thankful to have my boy here in my arms 💙

kennyfaith624
kennyfaith624
7 days ago

I wanted no monitoring when I was in labor. I wanted to be able to move around and do what I want. But because my water broke spontaneously without contractions. 15 hours after my water broke and still no contractions they gave me cytotec to speed things along. Because of this I needed continuing monitoring and I HATED it. The wireless one kept going out and then I had to be hooked up to a wired one 😫
Then! When I was pushing they had to put in an internal monitor because my son’s heart rate kept dipping to the 50s at every contraction. He had to be delivered with a vacuum and I pushed him out in 15 minutes. It was so uncomfortable but I’m glad we had the tools there to deliver my baby safely.

bethaniee_t
bethaniee_t
7 days ago

how come the babys heart rate doesn’t look like a “normal” one?

jessicanunciof
jessicanunciof
7 days ago

I felt so bad for the nurses that needed to keep adjusting the monitor!!! I was induced so I was on it for almost 2 days

alinavalor
alinavalor
7 days ago

During my labor nurses denied they could see my contractions (it would clearly rise every contraction) so I had to stay on the emf instead of following my birth plan … as a first time mom who also has done her research I noticed a few tactics used to not follow my birth plan and was made to feel incompetent.

jbmckenzie323
jbmckenzie323
7 days ago

This saved my baby during my induction. My contractions were consistent but I couldn’t feel them. One stop and didn’t let up and sent my baby into distress. (Uterus was compressing on baby and cord) Wouldn’t have know something was wrong unless 3 nurses came in gave me something to stop the contraction. Yes the monitors were annoying but they serve a purpose

louisequigley25
louisequigley25
7 days ago

I had to have an emergency c section because my babys heart rate was dropping so I am glad I had the monitoring 😊

makayla_lu
makayla_lu
7 days ago

During labor, EFM showed significant drops in his heart rate with each contraction, including once that he took a bit longer to come back up from. Because of this, we had an unplanned C-section that probably saved him. My sweet boy had a double nuchal as well as once around his abdomen. Very thankful for this necessary evil that caused earlier intervention and kept us both safe!

lauren_tolson
lauren_tolson
7 days ago

I’m thankful for people like you who informed me I could ask for intermittent monitoring.
Being able to walk around the ward (pre covid) was a life saver until I transitioned.

_rooguerrero
_rooguerrero
7 days ago

I’m on a L&D rotation right now and I swear I keep hearing the monitors even if I’m miles away from the hospital

Posted By Claire

Claire is our Community Manager here at New Moms Forum. A mom of two (almost grown-up babies), Claire has been building and operating community-based websites for almost 20 years. In her downtime, Claire enjoys spending time with her family and drinking copious amounts of red wine!

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