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insegnante
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| Posted: July 01 2008 at 5:18pm | IP Logged
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Can anyone tell me any happy stories about being able to move around comfortably and freely (okay, relatively) in labor with external fetal monitoring? Especially if it was constant and not intermittent monitoring? Or tell me some less happy stories so I can be realistic? I am actually going for a VBAC after two c-sections so obviously my previous births did not go ideally. The OB says "My patients always move around" (even with the EFM -- I guess he means without the epidural, though, and presumably some other exceptions!) I'm just having trouble picturing something different from previous experience of feeling very encumbered.
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Theresa
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Lisbet
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Did he define 'move around'? I can't picture it either...
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insegnante
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| Posted: July 01 2008 at 5:56pm | IP Logged
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Come to think of it, no. I just assumed he didn't mean "writhe in agony." 
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Theresa
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Elizabeth
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| Posted: July 01 2008 at 6:04pm | IP Logged
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I know my midwives allow pretty much everything with EFM--even a soak in the tub.
That said, you might actually find more freedom of movement with an internal monitor. It's much less likely to slip.I know that it was a relief to me in my first labor because I was able to get on all fours and lean against the back of the bed and squat and pretty much whatever I wanted. I couldn't walk laps but I could pace in the room.
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Elizabeth Foss is no longer a member of this forum. Discussions now reflect the current management & are not necessarily expressions of her book, *Real Learning*, her current work, or her philosophy. (posted by E. Foss, Jan 2011)
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Mackfam
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| Posted: July 01 2008 at 7:56pm | IP Logged
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Theresa,
I've done 3 VBACs - all in a hospital - so I can't speak to what a midwife might allow or not. I am monitored constantly, from start to delivery. I think what he means by move around is - you will be able to walk to the bathroom and back...sorry!
Moving around comfortably...well, I guess. There are 2 big elastic bands around your belly with goo all over. It's a little icky, and at first a bit of an annoyance, but nothing more than that. I took them off to go to the bathroom, climbed right back in bed, and kept on laboring with the monitors on. It was a comfort to hear the baby. Once active labor and pushing kicks in I don't notice them at all. If there are any signs of fetal distress, the internal monitor goes on, otherwise I request not to have it. I've only needed it on one baby so far.
Moving around freely...nope, not unless the monitors you'll be hooked to are different than mine. You're on a leash about 4-5 ft. long. You unplug to go to the bathroom. You waddle back and plug back in.
It certainly isn't like a home birth, but it's better than a C if you have the option. I'll be happy to answer any more questions about my experiences here, or you can PM me if you want.
It's getting close, Theresa! Praying for you!
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RamFam
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They make fetal heart monitors that are cordless, called telemetry monitors. These allow you to walk up and down the hallways of the L&D ward and around your room, while still monitoring. They are essentially the same as the ones Jennifer described above with the 'icky' elastic bands. Of course, with an epidural your movement is confined to your laboring bed.
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RamFam
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| Posted: July 01 2008 at 8:39pm | IP Logged
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Here is some information I found that might explain it better.
If I give birth in a hospital, what options for monitoring do I have?
Hospitals births typically require the use of electronic fetal monitoring. Ultrasound is still used to detect the baby's heart rate, however the ultrasound device is held in place over your lower abdomen by a stretchy and very snug belt. In addition, a second device, called a toco transducer, is placed over the top of your abdomen (or the fundus of your uterus) which is a pressure-sensitive gauge to measure duration and frequency of contractions. This toco transducer is not an accurate measure of the strength of contractions and only the mother will be able to tell her birth team about how strong her contractions truly are.
Both of these devices are attached by cables to a display unit that gives a graph print out, an audible signal as well as a constant visual signal of the heart rate as well as contractions.
Some care providers prefer that the laboring mother wear these two devices continuously in labor. However the American College of Obstretricians and Gynecologists has stated that low risk mothers may have the option of intermittent fetal monitoring. This allows the laboring mother to be free and mobile for about 20-30 minutes of each hour.
Can I be monitored but still be free to move about during labor?
There is another type of monitor called a telemetry, in which the laboring mother wears the same devices but instead of being attached via cables to the display unit, the ultrasound and toco transducer are attached to a radio-controlled device that the mother carries. She may be able to walk out of her room and around the labor and delivery floor while still having her baby's heart rate monitored. Not all hospitals have this portable monitoring device, so please ask your own hospital if this option is available.
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Elizabeth
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My VBAC was in the hospital with a midwife (and physician backup). Guess I wasn't clear there. I used an external telemetry unit that allowed me to walk all over and I could have soaked in a tub with it in the hospital if I'd wanted to do so.Constant monitoring is the hospital standard with a VBAC and I personally wouldn't want it any other way. But I got into any position I wanted. I walked the halls. I swayed back in forth trying to get the baby to move from posterior to anterior. I was up on the bed on all fours. The monitoring they used was as unobtrusive as I could have hoped it would be. In the past though, external monitors were attached at the bedside station and were "wired." I think I'd ask what it is exactly you're getting. If I have to be wired, I think the internal monitor actually offers more mobility.
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Elizabeth Foss is no longer a member of this forum. Discussions now reflect the current management & are not necessarily expressions of her book, *Real Learning*, her current work, or her philosophy. (posted by E. Foss, Jan 2011)
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Marie
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I was monitored for my whole first labour and delivery and it wasn't the telemtry kind. I found my movement very limited. That said, I took a birthing ball (or exercise ball) alot and I found this to be great. I could sit beside the bed on the ball and it gave me greater "movement". And then I got an epidural and couldn't have moved my legs if I'd wanted to. Its not easy but make the most of it and ask the nurses to help you with ideas!
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aussieannie
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I had one VBAC in hospital (but usually the're homebirths at home since the first birth resulted in a ceasar) and I immediately felt like a caged animal...very miserable indeed. I suppose I need my freedom mainly in second stage and I can remember when they said to me, "You mush push and get that baby out fast!" (because his heartrate was going down) I just hit that floor and cords and monitors went pinging off everywhere!!! They did try to encourage me gently up onto the table again but I was happy enough to do it surprisingly enough, but if I hadn't wanted to, I just wouldn't have listened to them and done my own thing...what can they do?
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insegnante
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I called the hospital and they don't have telemetry for fetal monitoring  I have been surprised to see multiple mentions in recent months of internal monitoring affording greater mobility as a positive side effect; I guess that could be a consolation if my water breaks early on, though I'll have to read about what placing the monitor means for infection risks. Waters not staying intact basically ultimately led to both my previous births going awry, so I've been hoping it won't happen at the start this time. (Getting plenty of Vitamin C for one thing...)
I think the doctor said until "4 or 5 cm" they wouldn't think I needed it, or at least not constantly. I know from experience that labor can still stall after that point though and I've had positioning/descent issues with my babies, so the idea of being stuck in bed just horrifies me! First time I was induced so I was on the monitor from the beginning and ended up getting an epidural anyway. Second time by the time I was first in the hospital there were already issues so that I didn't really expect a VBAC to work out, and under the circumstances and with the frequent and (seemingly) huge contractions, I didn't pay all that much mind to the monitors.
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DominaCaeli
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I had almost constant external fetal monitoring when laboring with my daughter, and it definitely restricted my movement--but I wasn't stuck in bed. The few feet's stretch of the cord did allow me to move around some even when I was tethered--I spent much of the labor standing up while leaning against the bed in its raised position. They also pulled a rocking chair and the physician's stool next to the machine at several points so that I could sit there instead of in bed. I could also have been on the floor if I had wanted to. It is definitely not ideal, and I felt much more comfortable without it, but there are ways to get around being totally trapped in bed.
The monitoring belt is not uncomfortable, but it definitely slips a lot and needs to constantly be re-positioned (at least in my experience). After a couple-days-long induction, my husband was an absolute expert at repositioning those sensors and taking my vitals so that the nurses wouldn't have to check in on us too often. 
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insegnante
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Thank you Celeste, that is reassuring. I vaguely recall now that keeping the thing on right was an issue with the monitor with my first child's birth. My husband is good with technical things, so maybe he'll be able to help. I am reading about "birthing balls" now because it sounds like they may be compatible with constant EFM.
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Rachel May
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I bounced happily along on the birthing ball and wandered the room or moved about in bed on my EFM tether with Joseph. When I needed to go, I had Bill unplug everything and help me to the bathroom...where I quickly gave birth. It was a surprise to everyone but a perfect delivery.
I was grateful to have my midwife intercede for me with the labor nurse as the nurse wanted me still and in bed so she could get a good strip, but the midwife would come and bail me out (Bill wasn't able to come until about an hour before the birth). Be sure to have someone speak up for you!
I also liked having an internal monitor when I've had those.
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Topic: moving around w/external fetal monitoring
