What You Need to Know About Wired vs Wireless Monitors in Labor

There is a lot of talk about wireless monitors for labor. Today I want to talk about the differences, how they are used and what to expect from them in labor. I’m also going to give you some tips in case a wired monitor is how it works for you in labor.

I actually recommend talking about your monitoring options in advance — it’s a part of my printable birth plan — grab it here:

Fetal Monitoring

First off, let’s talk about fetal monitoring.

There’s two parts to fetal monitoring:

Fetal Heart Rate Monitoring

The idea here is to catch any issues with baby as labor progresses by watching their heart rate. This is pretty complicated, as we watch how baby is doing. Labor nurses spend HOURS learning how to read the fetal heart monitor (honestly, probably more than doctors) and knowing how to respond.

I hear sometimes that people feel like THEY should know how to read the monitor, but I’m here to say that it’s complicated enough it likely isn’t worth it. You definitely want to get prepared for birth, but learning fetal monitoring is not the best use of your time. I think this is a better use of your time.

I also want to say the interpreting the fetal monitor is a science, but obtaining continuous monitoring is an art. Sometimes it involves extra parts, washcloths, extra tape – it is tricky and it’s a skill that labor nurses learn….

The odd fact is that studies really haven’t proven that this is as effective as we’d hoped in low-risk births — I’ll talk about that more in a minute — keep reading!

The fetal heart rate can be monitored using an ultrasound monitor, and also a fetal scalp electrode (FSE) in case we need to follow the baby closer, or the ultrasound isn’t picking up well and we need to see baby.

Wondering how an FSE works? We talk about it in here.

Contraction Monitoring

Beyond the fact that it is nice to know if you’re contracting and how long they are, Fetal HEART monitoring needs to be followed in association with contractions. If baby’s heart rate is dropping we need to know if it’s with a contraction or after it.

This can be monitored using a toco (long name: tocodynamometer) which measures the pressure of the uterus pushing on the monitor, or an IUPC (intrauterine pressure catheter) that is an internal monitor and is much more precise in how hard the uterus is contracting.

It can be temping to think that contractions measured using the TOCO can tell you how strong they are, but it really depends on where we place it, where baby is and your body dynamics. It really just shows us they’re happening, not how hard they are (I HATE it when a partner tells them — oh man, this is a HUGE ONE)….

Intermittent Auscultation

First off, this isn’t an option in a lot of hospitals.

Many hospitals boil this down to continuous fetal monitoring (often called intermittent monitoring) for about 20 minutes out of every hours, but intermittent auscultation is different.

I have a full post on it, which I would entirely recommend if you’re thinking this sounds like a nice option:

Intermittent Auscultation: Who it’s for (and why it’s better)

Here are the cliff notes:

• Your provider will listen to the baby (using a doppler) every 60-5 minutes (depending on your labor) before, during and after a contraction.
• It is ONLY for low-risk births, any higher risk things (including induction or epidurals) hospitals will require continuous monitoring
• 2/3 hospitals I worked for had no policy or even a way to chart for this — it’s an entirely different skill to learn than continuous monitoring
• This has been shown to reduce caesarean sections for lower risk births (again, tons more info and studies in that full article on it).

I am ALL FOR hospitals using this monitoring more, but as I discuss it in pregnancy groups/online I get a lot of moms who really enjoy seeing how their baby is doing all the time.

Until more pregnant patients are requesting it, it won’t be an option in many hospitals (because it requires more nurses, and more training to do it this way).

Want to know more hospital tips — check out these posts:

• The Three Biggest Mistakes Labor Patients Make—And How to Prevent Them
• Your Complete Guide to Epidurals in Labor: Everything You Need to Know
• 3 Proven Labor Secrets You Don’t Want to Labor Without!
• YOUR Birth Priorities: How to make them clear
• How To Have A Natural Hospital Birth

Ok, let’s talk about wireless monitors!

Wireless Monitors

These are monitors that can move with you. There are some monitors that still plug into a “transmission station” that I normally hung on an IV pole near you. They still had wires, but you could move about the unit freely.

As a note wireless and waterproof monitors are two different things (although some can be used both ways). Some wired monitors can be used like above in the bath — so ask your hospital their options (a great option when you go on a hospital tour).

However, there’s newer ones that are direct transmitters. The most often used one is called the Novii (also called the Monica).

It is used with the same heart monitor system we always have at the bedside but it transmits directly to those (we plug extra things into the monitor to pick it up).

Problems With Them?

Just like all the technology at your house — it sometimes doesn’t work.

There is a process of roughing up your skin to apply it (because it’s not an ultrasound, it’s catching electrical signals) and sometimes, no matter how much we try, it just doesn’t work.

I am in a very large labor nurse group on Facebook and a few times a week people are screaming how frustrated they are.

In fact, they just came out with a new generation — and I’m not hearing those work any/much better.

Who Can’t Use Them?

There are a few patients that we have the hardest time using them on, and that tends to be overweight patients.

Now, I’m an overweight girl myself (hello, Semaglutide) but the reality is that you have more fat over your uterus — which can make monitoring difficult.

Also, sometimes when you get up to walk your thighs rub against your belly, which can sometimes REALLY mess-up monitoring.

Yeah, I’ll be out there walking with you to try to fix it but it is sometimes impossible…

We can’t just magically make them work if we’re trying all the things and it won’t work.

I know a lot of people show these as magical cure that can help people move wherever in labor, but I am here to say it doesn’t always work that way.

SOMETIMES it does, and I love it — SO MUCH! It’s really frustrating that fetal monitoring hasn’t changed much since I started in 2001.

But, it isn’t always that magical cure….

Refuse Monitoring?

So, you get to the hospital and these things aren’t working and you’re miserable, can you refuse monitoring?

Absolutely.

Will that be really hard for your nurses & your provider?

Absolutely.

We’re very much trained to watch the monitor and act accordingly.

You need to realize that you’re refusing one of the main tools in our toolbox to see how your labor is progressing.

If you plan to refuse monitoring in labor, that is a conversation I’d have very early with your provider. It’s part of my birth plan series here:

Honestly, at the very least I’d want intermittent auscultation. Labor is a time that a lot can go wrong for the baby (and for you) — watching the baby once an hour should be your bare minimum. Again, you’ll want to find a hospital that truly does it and deliver there (and find a provider who also delivers there).

Tips for Wired Monitor Use

I think that a lot of people (and nurses) think that if you use wired monitors you have to stay in bed, and I’m here to testify that isn’t the case at all.

The wires on those monitors are pretty long, which is awesome — it gives us some great options!

Some of my favorite things to do with wired monitors:

Sit on a Yoga Ball or the Doctor’s Stool (personally, I think the doctor’s stool is one of the most under-used tools in the labor room, but I digress). This is a great way to stretch out your back, and legs while still feeling very supported.

Squats & lunges at the Bedside. I love to use those side rails as a ballet bar to allow us to move your hips in lots of ways to both open your pelvis but also stretch out your hip muscles as labor makes them awfully tight. I know walking gets a lot of love during labor, but I an a HUGE lunge fan….

Even if you’re not up for lunges, we often have a step stool in the room you could put one foot on and slowly sway or do circles with your hips — it just gives your pelvis a new spot to be in.

Dancing at the Bedside — you may not be up to drop it like it’s hot, but maybe some bear hug swaying with the one you love will get the juices going. BTW, music is something awesome to put on your birth plan — sometimes it remind your nurse to ask how you want to play it!

Let’s not discount awesome positions in the bed either. I love a Left Sims (I talk about that in this post), or even hands and knees on the bed (love the cushion of the bed vs the floor). All of these can be done while the monitors are plugged in!

Many hospitals also have peanut balls that can be used in the bed as well (with an epidural also).

This isn’t to say that these positions will always work either. In order to monitor you, we have to find & keep baby on the monitor, and while fetal monitoring is an art — sometimes it’s just not possible.

No matter the type of monitoring you have, I still recommend moving every 30 minutes that you’re not asleep. I talk about that a LOT in here (and give tips for partners to help — because this is a GREAT way for them to be a teammate).

The Nurse Monitoring Bugs You

I’ve seen a few posts on social about how much people hate the nurse moving the monitor.

I’ve even seen people saying they hit their nurse because they kept adjusting it.

First off, I 100% understand being annoying (we’re also annoyed) but hitting a nurse is absolutely NEVER OK.

You have two choices, you can be monitored, or you refuse the monitoring.

If you’re making the choice to be monitored, your nurses is likely going to need to adjust it a lot. She may not ask every time she has to adjust (because it is sometimes like every 5 minutes). Should she? Yes — but she has a lot on her plate and she figures you want the monitor, so she needs to fix it.

If you don’t want her to adjust the monitor then that is refusing monitoring. It’s not fair to put that on the nurse.

I know some people say “don’t touch it when I’m having a contraction” — but the problem is that often the problem time to get baby on is during a contraction (as the moves the baby). If you want monitoring, it may come with her adjusting it during a contraction.

That’s just how it is.

Intermittent monitoring is amazing, but can’t be used with every birth. Also, you have to realize that even with that type of monitoring the nurse will be listening to the baby at every point and may need you to move to be able to access your belly whenever they need to listen.

I just think a lot of people aren’t aware of how annoying monitoring can be during labor, so I hope this article was helpful and helps you understand your options!

I think there’s a LOT that people don’t understand about labor ahead of time — this is why I recommend an expert, unbiased birth class. I recommend this one. It is:

• Affordable — not the $400 ones a lot of doulas like to offer
• Quick — in just 3 hours you can be prepared with the basics for birth
• Created to help your partner be a teammate, not just a cheerleader

Thousands of couples have taken it, be sure to read the reviews, they’re definitely what convinced me that class rocks.

So, what type of monitoring are you planning for during your birth? Did this open your eyes to how wired & wireless monitoring works? Let me know in the comments!