Electronic Intrapartal Fetal Monitoring--Any Suggestions in Teaching?

[VickyRN, MSN, DNP, RN]

Will be teaching fetal monitoring soon for my ADN students. I have worked as an L & D nurse, so the concepts themselves I understand. It is just in communicating these to the students that I am asking for suggestions.

Another question--I have been reviewing different textbooks and scholarly sources and see conflicting data about the benefit of EFM. Some textbooks claim there is NO benefit (no decrease in perinatal mortality, no decrease in cerebral palsy) plus an increase in surgical interventions (c-sections and forceps deliveries). Another source claimed that EFM DOES decrease the rate of perinatal mortality. My question--if EFM does NOT decrease perinatal mortality, THEN WHY ARE WE USING IT? Does any hospital or facility still use intermittent fetal monitoring with a Doppler or fetoscope for low risk patients?

[SmilingBluEyes]

Where I work, we use intermittent monitoring for low-risk patients where I work and it works well. NO ONE who is doing well, laboring normally, and who is low-risk has to stay on the monitor at all times.

The only times we insist on continuous fetal heart monitoring is when a person is considered at risk (severe diabetes, heart conditions, severe PIH, etc---- or on medications that can affect her and her fetus such as pitocin, magnesium, or have anesthesia in place----- etc. Or if their baby shows signs of compromise in-utero.

Where are they doing continuous monitoring on low risk patients? I don't know of such a place near me. They moms are encouraged to get up and move about in labor as much as possible with the monitors OFF-------it's up to them.

[VickyRN, MSN, DNP, RN]

Where are they doing continuous monitoring on low risk patients? I don't know of such a place near me.

All-too-common practice around here (Eastern NC). However, a LARGE percentage of our clientele are high-risk to begin with (DM, HTN, etc).

[bagladyrn, RN]

Mostly I think continuous EFM is being used in low risk labors because of the threat of litigation. If anything untoward should occur, and it were not being used, there goes the case. It's a sad commentary on our times that patients are being subjected to many interventions simply to ward off lawyers. Might be an interesting topic to bring up with your students.

[VickyRN, MSN, DNP, RN]

Might be an interesting topic to bring up with your students.

Definitely! Unfortunately, L&D is the speciality in which 80% of law suits occur. Parents can sue until the child is 18 years old... and then, the child can sue from 18-21 years!