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The American Journal of Nursing Vol. 82, No. 5 (May, 1982) , pp. 813-822 (10 pages) Published By: Lippincott Williams & Wilkins https://doi.org/10.2307/3463044 https://www.jstor.org/stable/3463044 Read and download Log in through your school or library Journal Information The American Journal of Nursing (AJN) is the oldest and largest circulating nursing journal in the world. The Journal's mission is to promote excellence in professional nursing, with a global perspective, by providing cutting edge, evidence-based information that embraces a holistic perspective on health and nursing. Clinical articles focus on acute care, health promotion and prevention, rehabilitation, emergencies, critical care, home health care, etc. Columns present additional perspectives on clinical care, such as ethics, the law, practice errors, pain and symptom management, and professional issues. Publisher Information Wolters Kluwer Health is a leading provider of information for professionals and students in medicine, nursing, allied health, pharmacy and the pharmaceutical industry. Major brands include traditional publishers of medical and drug reference tools and textbooks, such as Lippincott Williams & Wilkins and Facts & Comparisons; electronic information providers, such as Ovid Technologies, Medi-Span and ProVation Medical; and pharmaceutical information providers Adis International and Source®. Wolters Kluwer Health is a division of Wolters Kluwer, a leading multi-national publisher and information services company with annual revenues (2005) of €3.4 billion and approximately 18,400 employees worldwide. Wolters Kluwer is headquartered in Amsterdam, the Netherlands. Its depositary receipts of shares are quoted on the Euronext Amsterdam (WKL) and are included in the AEX and Euronext 100 indices. Rights & Usage This item is part of a JSTOR Collection. Your baby’s heart rate is usually monitored during labor. This is called fetal heart rate monitoring. It is done to keep track of your baby’s heart rate. Your doctor uses special equipment to listen to the baby’s heartbeat. This helps the doctor detect problems with the baby if they develop. It also helps reassure the doctor and you that labor and delivery are going normally. Path to improved healthYour doctor will want to monitor your baby during labor. The easiest way to do this is through fetal heart rate monitoring. He or she can see how your baby is handling contractions. It helps them make sure the baby is doing okay. Your doctor can monitor the baby either externally or internally. Externally means the sensors that monitor the baby are outside of your body. Internally means the sensors are put inside your body. Most women are monitored externally. Internal monitoring can be used if there is cause for concern or the doctor needs more exact information. External monitoringThe simplest form of monitoring is called auscultation. This is a method of listening to the baby’s heart rate periodically. Your doctor will use a special stethoscope or a device called a Doppler transducer. He or she will press the device against your abdomen to listen to the baby’s heartbeat. They will do this at set times during labor, such as every 30 minutes. If you are at risk of having problems or if problems develop during labor, you will be checked more often. Some women prefer auscultation because it gives them the freedom to move around during labor. The most common form of monitoring is external electronic fetal monitoring. This is when sensors are strapped to your abdomen. The baby’s heart rate is monitored continuously. Instruments record both the baby’s heartbeat and your contractions. This helps your doctor see how your baby is responding to the contractions. The recording doesn’t stop. Your doctor can check it at set times and see how labor has been going overall. The sensors remain on your abdomen for all of labor. You usually need to stay in the bed most of the time. Internal monitoringIn this method, an electrode attached to a wire is placed directly on the baby. This monitors the heartbeat. A sensor is strapped to your leg. The electrode is threaded through your cervix and into the uterus. There it is attached to your baby’s scalp. A small tube can also be inserted to measure contractions. The two can provide more accurate measurements of your baby’s heartbeat and your contractions. This kind of monitoring is usually done if the external monitor isn’t picking up well. This could be because you are moving around a lot, or if you are obese. Your doctor may want a more accurate reading for other reasons. These could include risk factors or possible complications. This method can only be used if your cervix is dilating and your water has broken. Pros and consSome women don’t want to be continuously monitored. You can’t move around with it. It takes away options for pain relief during labor, such as walking. Yet many doctors want you to do it. Your wishes could affect where you choose to have your baby. For example, you won’t have electronic fetal monitoring in birthing centers or at home. If you don’t want continuous monitoring, talk to your doctor as soon as possible. Fetal monitoring can sometimes detect a problem when there isn’t one. If it shows an irregularity, your doctor may decide your baby needs to be delivered sooner. He or she could recommend giving medicine to speed up labor. Or they could decide to use forceps or a vacuum-assisted delivery. But sometimes the irregularity could actually be indicating nothing. Then the baby is born sooner and with assistance for no reason. What kind of monitoring do I need?Auscultation is generally considered an acceptable form of monitoring if:
You will need continuous monitoring if:
Things to considerWhat is considered normal for my baby’s heartbeat?Indications that everything with the baby is fine include:
What is not normal for my baby’s heart rate?Signs that there could be a problem include:
What if my doctor detects a problem?Changes in heart rate do not necessarily mean there is a problem. Some are natural, such as it increasing when your baby moves or during a contraction. These changes are considered signs of well-being in your baby. If your baby’s heart rate is very rapid or dips down, there are some simple changes your doctor may suggest:
Other things your doctor could do include:
If none of these interventions help, your doctor may consider speeding up delivery. To do this, you could have an assisted delivery. Your doctor uses forceps or a special vacuum to pull your baby out instead of waiting for the contractions to push him out. Or they may suggest you have a c-section. Questions to ask your doctor
 Copyright © American Academy of Family Physicians This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject. How often should the nurse check the mother's blood pressure during labor?Assess the woman's pulse and blood pressure every 15 minutes to be certain of a safe induction. Monitor uterine contractions and FHR accordingly. Contractions should occur no more often than every 2 minutes, should not be longer than 70 seconds, and not stronger than 50 mmHg.
How often should blood pressure be checked in labour?Labour and birth
As long as your blood pressure remains within target levels, you should be able to have a natural vaginal birth. If you have severe hypertension, your blood pressure will be monitored every 15 to 30 minutes in labour.
What should you monitor after administering oxytocin?Monitoring. Electronically monitor the uterine activity and the fetal heart rate throughout the infusion of Pitocin. Attention should be given to tonus, amplitude and frequency of contractions, and to the fetal heart rate in relation to uterine contractions.
How often should vitals be taken during active labor?2.3.
Count the number of fetal heartbeats for a full minute at least once every 30 minutes during the active phase first stage of labour and every 5 minutes during the second stage.
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How often should the mothers blood pressure and pulse rate be checked during oxytocin infusion?
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