Summary

The decision on whether to expose your unborn child to ultrasound during an uncomplicated pregnancy remains a personal one, hopefully made with full and careful consideration of all risks versus the benefits. And of course ultrasound can never substitute for the clinical skills and judgment of the attending physician.

For Further Reading

A GUIDE TO EFFECTIVE CARE IN PREGNANCY AN CHILDBIRTH, by Iain Chalmers, Murray Enkin and Marc Keirse (Oxford University Press, 1989). This is a summary of the effects of care during pregnancy and childbirth, based on over 3,000 studies.

EVERY WOMAN'S GUIDE TO TESTS DURING PREGNANCY, 1986, by the Coalition for Medical Rights of Women, 2845 24th St, San Francisco, CA, 94110. 415-826-4401.

Addendum On Electronic Fetal Monitoring

The electronic fetal monitor (EFM) tracks the fetal heartbeat and records the uterine pressure during contractions. Introduced in the 1970's, EFM was initially used for high risk pregnancies. Before the proper studies had been completed, it became a routine practice in most Canadian and American hospitals. Currently 80 percent of women having babies are exposed to some type of fetal monitoring.

Recent research has shown that EFM, compared to the use of intermittent heart beat checks by a caregiver, does not improve the outcome for the baby. In fact, routine use of EFM increased the C-section rate. This was true even for women in the high risk category.

What Is Efm ?

The external EFM consists of two straps which go around your abdomen. One strap holds a pressure gauge to record contractions and the other strap an ultrasound transmitter to detect the baby's heartbeat. The information provides a continuous printed record of heartbeat and contractions.

With the internal fetal monitor, an electrode is inserted into the baby's scalp and linked to a recording device by a wire inserted though the mother's vagina.

The Disadvantages Of Efm

• Mother confined to bed during labour.

• Beeping alarm if mom changes position.

• EFM machines frequently break down and malfunction.

• Wide variation in EFM interpretation.

• False alarms can only be sorted out through taking fetal blood to measure the oxygen level.

• Can substitute for regular checking by the care giver.

Other Options Of Efm

Find out when your doctor uses EFM. Request your baby be monitored without EFM, if the staff is available.

Doppler stethoscopes may improve the reliability of fetal monitoring versus the ordinary fetal stethoscope.

Soothing presence, touch, words of caregiver or labour coach can decrease complications.