If the information from the fetal monitor raises concerns or is ambiguous, your practitioner can perform other tests to help determine how to proceed with your labor.
Labor admission test
This test involves performing electronic fetal heart rate monitoring for about 20–30 minutes upon admission to the labor and delivery floor. It is a good way of initially assessing fetal well-being, and may be helpful in quickly identifying those rare occasions where the fetus needs quick delivery.
Scalp pH
If your practitioner is concerned about how well the baby is tolerating labor, he may want to perform a scalp pH test. This involves sampling a small amount of the baby’s blood through a little prick of his scalp and measuring the pH, which reflects how well the baby is doing during labor.
This test requires that the cervix is dilated enough to access the fetal scalp. Many labor floors no longer have the machinery to perform this test because the machines require a lot of maintenance and quality control.
Scalp stimulation
Scalp stimulation is an easy test to see how the fetus is doing. The practitioner simply tickles the baby’s scalp during an internal exam. If this touch causes the fetal heart rate to increase, the baby is usually doing fine.
Some practitioners, and some mothers, prefer not to monitor. But most doctors believe that monitoring is very useful and the benefits that monitoring provides outweigh any risk that monitoring may lead to an unnecessary cesarean delivery.
Fetal pulse oximetry
Another potential way of assessing fetal well-being is by measuring fetal oxygen saturation. There are a variety of ways this can be measured, including one that attaches to the fetal scalp or a probe that sits inside the mother’s vagina. However, at this time there isn’t good data to clarify how it improves newborn outcome beyond regular fetal heart rate monitoring.
