How often do you document fht's? - page 2

by at your cervix

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I am curious to know what other hospitals are doing. According to AWHONN guidelines, a pt that is low risk should have fhr documented q30 min in active first stage of labor, however, it should be q15 min if high risk. Does... Read More


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    We do q 30 in early labour, q15 in active and q5 in second stage. Q15 if there is an epidural or oxytocin. The facility in at now doesn't favor IA but my last hospital had the same guidelines for either IA or continuous. My last facility allowed for interruption of continuous if oxytocin was stable for up to 30 minutes (with IA at the 15 minute mark) to allow for walking and showering etc. The facility I'm at now certain docs don't mind but most want continuous all the time I think up here in Canada the policies pretty much say the same thing across the board but the interpretation varies. I always go by my policy--and what the situation is at the time I.e. if I have someone in early labour who seems to be picking up quickly I'll move right to q15.
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    Just curious, you are talking about continuous aren't you? Doesn't that cause issue with requiring the woman to lay in bed throught her labour? Or do you have portable monitors? Do you get many women that refuse? Or place their own restrictions? Say Doppler once an hour or something?
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    My first two jobs we didn't have portable telemetry monitoring so if the woman needed to be continuously monitored we were limited to using the bed for positioning or the birthing ball/standing next to the bed. My current facility has telemetry that even works with our scalp clips so women can walk or be up even if they need to be on continuous. It's great and usually works fairly well!

    I have always preferred IA in any low risk situation but many OBs I have worked with are still very uncomfortable with it. My current hospital requires continuous monitoring during an epidural because one time a baxillion years ago a woman sat up for an epi and had a cord prolapse when her water broke and the outcome wasn't good. Stupid knee jerk reaction. A policy indicating IA in case of SRM would be just as safe and a lot easier IMO.
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    Quote from Michelle123
    Just curious, you are talking about continuous aren't you? Doesn't that cause issue with requiring the woman to lay in bed throught her labour? Or do you have portable monitors? Do you get many women that refuse? Or place their own restrictions? Say Doppler once an hour or something?
    I would refuse the hell out of it My body can't do what it's supposed to when I'm laying down. I was a walker and a squatter during my two labors.
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    We have continuous monitoring with several centralized monitors at the nurses stations, break room, Dr on-call rooms, etc so if a baby looks to have an issue, there are many eyes on it. However if someone is in early labor with no issues then we will document q hour. Once pit is started or there's an epidural or transition, then we document q 30 minutes.
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    Like most of you, we document q 30 with no intervention and q 15 once there is pit or an epidural. Part of protocol upon admission is continuous monitoring. Not many women complain since most don't get admitted unless they want an epidural. We only do intermittent monitoring (15 minutes on, 45 minutes off) with a written order.


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