Electronic Fetal Monitoring During Labor and Delivery

7 min read

Written by Suma R P

Suma R P

Electronic Fetal Monitoring During Labor

Every pregnancy is different. Some may get through the phase with fewer issues, while others can experience a lot of them. In such cases, fetal monitoring holds a vital place at the time of labor and delivery. It helps the care provider to decide if there is any problem with the fetal heartbeat. This is also useful to decide the emergency and the type of care a particular pregnancy might need. Electronic fetal monitoring during labor and delivery is crucial in certain circumstances.

Fetal monitoring can help doctors identify the problem quickly. Based on the intensity of the problem, doctors will decide the type of delivery. We gave a brief description of Electronic Fetal Monitoring (EFM) during labor and delivery and when and why it becomes important.

In This Article

Video of When to Opt For EFM During Labor and Childbirth?

Types of Fetal Monitoring

Fetal monitoring is the process or test with which your doctor or health provider will monitor your baby’s heart rate, heart functioning, and several other functions. This is a routine procedure and will continue through your pregnancy and during delivery.

This fetal monitoring is of two types.

1. Continuous Fetal Monitoring

Doctors carry out this kind of fetal monitoring with an electronic device. This is a procedure to identify the heartbeat of the baby inside the uterus continuously. Doctors may suggest this procedure for high-risk pregnancies. Continuous fetal monitoring restricts the movement of the mother.

2. Intermittent Fetal Monitoring

Intermittent Fetal Monitoring

A special stethoscope called a fetoscope is used in normal intermittent fetal monitoring. Doctors majorly prefer this for unmedicated pregnancies which do not have any problem during labor. Intermittent fetal monitoring is carried out at specific intervals of time.

Doctors also conduct this intermittent fetal monitoring using a Doppler transducer. A Doppler transducer connected to a computer displays the heartbeat of the fetus. Doctors use a gel conductor which they apply to your belly and place the Doppler transducer. By moving the transducer accordingly, they will monitor the heartbeat of the fetus. Intermittent fetal monitoring can allow you to move around during the gaps.

Electronic Fetal Monitoring – What is it?

Electronic Fetal Monitoring procedure

Electronic Fetal Monitoring or EFM is used to check the fetal heartbeat. Care providers and doctors carry out this procedure to identify if there is any problem with the baby’s heartbeat inside the uterus.

The Procedure

Doctors use an ultrasound transducer which is also called a probe and a pressure sensor. They determine the fetal heartbeat and uterine contractions. An ultrasound transducer works by capturing the echoes from the body. The computer connected to this receives them in the form of an image. Doctors take a print of it to analyze the baby’s heartbeat.

A tocodynamometer (pressure sensor) is wrapped around your belly. This helps in monitoring the uterine contractions accurately.

Based on these two reports, doctors decide the type of delivery a woman would need. Electronic Fetal Monitoring is a method that indicates an underlying problem that necessitates immediate attention.

Types of Electronic Fetal Monitoring

There are two types of electronic fetal monitoring. They are

1. External Electronic Fetal Monitoring

External Electronic Fetal Monitoring

This is a kind of fetal heartbeat determination that the doctor carries out externally. An external electronic fetal monitoring determines the fetal heartbeat by sending the captured sound waves to a computer. It includes a transducer and a belt wrapped around the belly. A transducer converts one form of energy to another.

An ultrasound transducer or a probe used in this method is connected to a computer. It sends sound waves (echoes) to the computer screen. Doctors see the sonogram formed and take the printout of it to analyze the heartbeat of the baby inside the uterus.

External electronic fetal monitoring is connected to a computer. You may have to settle on the bed during labor. Getting up and walking may not be an option available in such cases. Doctors may continue to monitor the fetal heartbeat even during the process of delivery.

A tocodynamometer is also wrapped along with the probe. This works on the principle of transducers and helps in identifying the exact uterine contractions. Doctors may continue to monitor the fetal heartbeat using this method even during the process of delivery.

External electronic fetal monitoring helps doctors in many ways to conduct safe labor. This can also assure you and your partner are in safe hands.

2. Internal Electronic Fetal Monitoring

Doctors conduct internal electronic fetal monitoring very rarely. They prefer this method if they know to expect fetal distress.

Fetal distress can happen for the following reasons

  • Type 1 diabetes during pregnancy.
  • A complicated pregnancy.
  • Suspected infections in the pregnant woman.

Internal electronic fetal monitoring is a method where a small electrode is inserted internally. Doctors will connect this directly to the baby’s head. A computer connected to these wires will display the results. This can help doctors identify the complexity of the labor. In case of emergency, doctors may need to perform a cesarean section.

[Read: Increased Prevalence Of Elective Caesarean Delivery]

Purpose of Electronic Fetal Monitoring During Labor and Delivery

Doctors prefer to conduct external and internal electronic fetal monitoring to check the heartbeat of the fetus during labor and delivery.

External electronic fetal monitoring can help them understand in:

  • Deciding the type of delivery.
  • Identifying the pace of labor.
  • Identifying abnormalities like a decelerated or accelerated heartbeat of the baby.
  • Quick diagnosis in case of fetal distress. Fetal distress is a word used to imply the unwell baby inside the uterus. This happens when the baby inside the uterus does not get enough oxygen.
  • Assure parents of a safe and sound delivery.

Internal electronic fetal monitoring can help the decide:

  • For a cesarean section and other assisted deliveries if needed.
  • Avoid infections
  • Avoid fetal deaths because of the expected or unexpected fetal distress.
  • Assure parents of a safe and sound delivery.

[Read : Assisted Vaginal Delivery Methods]

When to do Electronic Fetal Monitoring?

doctor analysing report

Your doctor may decide to do electronic fetal monitoring in one or more of the following conditions.

  • Doctors carry out electronic fetal monitoring using a doppler transducer during intermittent visits.
  • For high-risk pregnancies.
  • To analyze the fetal heartbeat. This can help doctors understand the complexity and take quick actions to deliver a healthy baby.
  • If the doctors expect any kind of fetal distress.
  • If there is any unexpected fetal distress identified during normal intermittent fetal monitoring.
  • Doctors prefer to do the procedure if the baby has any chance of acquiring infections.
  • In case of any expected complications during the phase of pregnancy like gestational diabetes and other diseases.

When Not to do Electronic Fetal Monitoring?


Doctors do not prefer conducting electronic fetal monitoring if the pregnancy phase is smooth. They do not prefer this if the mother and the baby are healthy and are expected to have a sound delivery. Electronic fetal monitoring may not be necessary for normal and healthy pregnancies. For such cases, doctors prefer the normal use of a fetoscope. They also opt to do intermittent electronic monitoring using a Doppler transducer to check the heartbeat of the baby.

[Read: Doppler Scan During Pregnancy]

Risks of Fetal Monitor to the Baby and the Mother

Electronic fetal monitoring comes with certain risks. It is important to discuss this with your doctor and know the risks beforehand.

Risks to the Baby

Internal electronic fetal monitoring can cause bruising on the baby’s head. The transducer placed on the baby’s head is responsible for the wound. It can heal on its own after delivery. Some babies may suffer from breathing problems.

Risks to the Mother

  • It can deprive you of having a normal delivery.
  • Increased chances of assisted deliveries like.
  • Cesarean section, forceps-induced delivery, vacuum-induced delivery.
  • Cuts and wounds to the genital areas.
  • Increased bleeding.
  • Urinary tract infections and other increased risks of infections.

Electronic fetal monitoring plays an important role in saving babies from fetal distress. This can also help in avoiding high-risk pregnancy complications. Assuring safe delivery, doctors help you get through if there is an unexpected complication during labor.

It is always important to get an assurance on how your baby is handling the labor and delivery. Talk to your doctor regarding the risks of fetal monitoring. Discussing with them can help you understand what your body is going through. This can give a positive experience to you and your partner during labor.


1. Why do Doctors Perform Electronic Fetal Monitoring?

Electronic fetal monitoring helps in monitoring the heartbeat of the baby. Doctors do this to avoid complications during labor and delivery.

2. What Are the Types of Electronic Fetal Monitoring?

There are two types of electronic fetal monitoring:

  • External
  • Internal

Doctors use an ultrasound transducer or a probe and wrap it using a belt to the belly. They see the results on the computer. Doctors insert an electrode internally. They attach the end of the wire to the head of the baby.

3. What is a Normal Fetal Heart Rate During Labor?

The normal fetal heart rate during labor is 110-160 beats per minute. Doctors check for accelerations and decelerations by fetal monitoring.

Read : What Are My Chances Of A Normal Delivery?

Suma R P,M.Sc (Organic Chemistry) Rayalaseema University B.Sc (Biotechnology) Sri Krishna Devaraya University.

Suma is a passionate content writer with a strong keenness to understand the miracle of pregnancy, birth, and parenting. Suma has successfully transitioned into a full-time content writer and a key contributor at Being The Parent. She leverages on her experimental background in chemistry and experience in writing to come up with well-researched content that helps parents struggling to deal with various medical conditions of their children.Read more.

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