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What are Fetal Heartrate Monitors?

September 16, 2020

A fetal heart monitor is a handheld medical device that uses ultrasound waves to listen to a baby’s heart during pregnancy and labor.

It’s also known as electronic fetal monitoring (EFM) or cardiotocography (CTG).

Usually, beginning in a pregnant woman’s second trimester, her OB-GYN will use a fetal heartrate monitor to check on the baby’s heart rate and rhythm. This information helps doctors determine the baby’s growth and development in utero.

The baby’s heartbeat can typically be heard on a Doppler fetal heartrate monitor between nine and 12 weeks of pregnancy. So, a doctor might start listening to the baby’s heart at a woman’s three-month checkup.

Most important, EFM is used during labor to listen to the baby’s heart and make sure he or she is tolerating labor.

What Does a Fetal Heartrate Monitor Track?

Once an OB-GYN starts using a fetal heartrate monitor, it typically is used on every subsequent visit to compare the readings. The sound of the baby’s heart can tell the doctor quite a bit about his or her overall health. So, it’s completely routine for the doctor to use a fetal heart rate monitor at every prenatal checkup beginning at nine to 12 weeks. EFMs are used to check the following:

  • The baby’s heart rate;
  • The baby’s heart rhythm; and
  • The baby’s overall health in utero.

In What Cases Might a Doctor Use Fetal Heart Rate Monitoring More Often?

The doctor is more likely to use fetal heart rate monitoring when a woman’s pregnancy is high-risk. These high-risk circumstances include the following:

  • The woman has diabetes or high blood pressure;
  • The woman is taking prescribed medicine for preterm labor; and
  • The fetus isn’t growing or developing normally.

Fetal Heart Rate Monitoring During Labor

In addition, doctors often use a fetal heart rate monitor during labor to be certain that the baby is stable and in good condition. Fetal heart rate monitoring in labor can help identify changes in the baby’s normal heart rate pattern. If the doctor sees certain changes, he or she can act to help treat the underlying problem.

What if the Baby’s Fetal Heart Rate Pattern is Not Normal?

It’s important to know that a baby’s abnormal fetal heart rate pattern doesn’t necessarily mean there’s a serious issue. The doctor will perform other tests to determine if there’s a problem with the baby.

When an abnormal fetal heart rate pattern is detected, the OB-GYN or other healthcare professionals will try to find the cause. For example, the patient could be instructed to change positions to help the baby get more oxygen. Or, the mother could receive supplemental oxygen. If this doesn’t return the fetal heart rate to a regular pattern, or if further test results suggest the baby has a problem, the medical team may decide to deliver the baby immediately by C-section.

What is the Importance of Fetal Heart Monitoring During Labor?

Fetal heart monitoring is an extremely valuable tool in prenatal care and labor. There are no significant downsides or risks. Even so, there are a few things to know about fetal heart monitors

As mentioned earlier, there’s a chance that the OB-GYN will suspect a problem with the baby’s heart based on the reading of the fetal heart monitor. An inaccurate reading can lead to additional testing. This can create additional stress in an already stressful situation, especially if this occurs during labor.

However, if there is a true problem, it may be fetal distress. This means that the baby is not getting enough oxygen or other nutrients. The baby receives oxygen from the mother’s oxygenated blood, which requires the transfer of oxygen from the mother’s blood to the baby’s blood via the placenta. If the baby is injured because of an issue that’s not detected with a fetal heart monitor, the mother and family may bring a lawsuit against the doctor and hospital.

It’s not common that the fetal heart monitor on its own could have prevented a birth injury. However, some injured women contend that the physician’s complete course of medical care during the labor and delivery caused a delay, and that an asphyxic brain injury was the result of the OB-GYN’s breach of the standard of care.

Fetal heart monitoring is critical in a pregnancy and during labor because there are so many things that can go wrong in the procedure. The baby’s condition can deteriorate quickly during labor, and accurate readings of the baby’s heart rate are paramount. If the fetal monitor shows that the baby isn’t getting sufficient oxygen, physicians must take immediate action to save the life of the baby. The warning signs include:

  • Prolonged decelerations;
  • Loss of variability;
  • Bradycardia;
  • Decelerations with slow returns to baseline;
  • Repetitive decelerations; and
  • Uterine hyperstimulation.

If an OB-GYN or other member of a healthcare team don’t use a fetal heart rate monitor as indicated, uses it incorrectly, improperly interprets the monitor’s readouts, or fails to act when they should, the consequences could be serious.

If the baby is injured by negligent actions connected to the use of a fetal heart rate monitor, it can be medical malpractice.


It’s important that your OB-GYN and medical team are certain that their fetal heart monitors (EFMs) are accurately recording information. Pregnant women and their supporting families should be educated on how the monitor works, what the readings mean, and what the monitor’s alerts may signal. Patients should feel free to ask their nurses and doctors about the function of the fetal heart monitor.

If you or a loved one believes that something went wrong during a delivery, such as a birth injury or unforeseen complication that should have been detected by a fetal heartrate monitor (EFM), contact Buchanan Firm for a free consultation with an experienced Michigan medical malpractice attorney. We can discuss your situation if you believe you’ve been injured as the result of a medical error during your pregnancy.

Our firm proudly serves people all across Michigan, including major cities like Grand Rapids, Muskegon, Detroit, Lansing, Holland, St. Joe, and Ann Arbor, and rural towns such as Lowell, Ada, Fremont, Newaygo, Grand Haven, Rockford, and Cedar Springs. We will meet you after-hours, at home or in the hospital to accommodate you.

Contact us today!