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Pregnancy

Why Home Fetal Heart Rate Monitoring can be Harmful

Jennifer Lincoln, MD, IBCLC, Board Certified OB/GYN
January 3, 2019 . 3 min read

When you go to a hospital or birth center when you are in labor, your baby’s heart rate can be monitored to make sure he or she is tolerating the labor appropriately. This is a longer version of when your doctor or midwife checks on your baby’s heart rate at your prenatal visits, using a fetal Doppler. But should expectant parents monitor their baby’s heart rate at home?

As you’ve probably seen at your prenatal visits, fetal Dopplers are small hand-held devices that detect your baby’s heartbeat. They are usually powered by batteries, and when ultrasound gel is placed on a small transducer probe that is then put on your abdomen, your baby’s heartbeat can be heard by everyone in the room. This is usually the most anticipated part of most prenatal visits!

Personal-use versions of these Dopplers are available online and in some baby supply stores. Given that they are easy to access and usually affordable, some moms purchase one to help reassure them in between visits that their baby is doing alright. However, this can sometimes lead to more problems.

Finding a baby’s heartbeat is not always so easy—even for many obstetric providers! If a woman tries to listen when the baby is still very small (such as in the first trimester), she may not be able to find it and face undue anxiety that something is wrong. Additionally, obesity makes listening to the heartbeat more difficult, as does a baby’s position.

Another complicating factor is accurately determining a baby’s heart rate. With a normal range of 110 to 160, it occasionally will go higher and lower. For example, just like your heart rate increases with activity, so does a baby’s. A woman may see that her baby’s heart rate is 170 and think this is a problem, when really it was just the normal acceleration associated with movement. In a different situation, she may see that same heart rate and think it is only because her baby moved, when actually it is a sign of distress because it is persistent.

Lastly, determining whose heart beat is whose can be tricky. It can be hard to tell what pulse belongs to the mother and what belongs to the baby (especially since they sometimes overlap!). This can be a problem if a woman assumes the heart rate of 60 that she heard was hers when in reality it was her baby’s (and this is far too low and may signal severe distress).

Home Dopplers can cause both false worry and false reassurance. They can lead a woman to undergo lots of unnecessary anxiety and testing (such as in the case of not being able to find a heartbeat at home, which prompts a visit to labor and delivery), and they can also lead to ignored warning signs (such as when a woman hasn’t felt her baby move much, thinks things sound fine on her home Doppler, and doesn’t alert her obstetrician when a real problem is present).

Still, many women find them hard to resist since listening to your baby’s heartbeat can be one of the most fun parts of pregnancy. If this is the case with you, be mindful of their drawbacks when used at home. Be sure to still follow your doctor\’s or midwife’s guidelines when it comes to alerting them with concerns, and if you find that home Doppler use causes you more anxiety—feel free to throw it out.

Sources:

  • The American College of Obstetricians and Gynecologists
  • FAQ#15: Fetal heart rate monitoring during labor.
    A Chakladar and H Adams
  • Dangers of listening to the fetal heart at home
  • BMJ 2009; 339:b4308.

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