Editing Childbirth (section)

===Fetal monitoring===

For external [[monitoring (medicine)|monitoring]] of the fetus during childbirth, a simple [[Pinard horn|pinard stethoscope]] or [[doppler fetal monitor]] ("''[[doptone]]''") can be used.
A method of external (noninvasive) fetal [[monitoring (medicine)|monitoring]] (EFM) during childbirth is [[cardiotocography]] (CTG), using a ''cardiotocograph'' that consists of two sensors: The ''heart'' (cardio) sensor is an [[ultrasonic sensor]], similar to a [[Doppler fetal monitor]], that continuously emits ultrasound and detects motion of the fetal heart by the characteristic of the reflected sound. The pressure-sensitive ''contraction'' transducer, called a ''tocodynamometer'' (toco) has a flat area that is fixated to the skin by a band around the belly. The pressure required to flatten a section of the wall correlates with the internal pressure, thereby providing an estimate of contraction.<ref>{{cite book |title= The Medical Equipment Dictionary | vauthors = Hammond P, Johnson A | veditors = Brown M |publisher= Chapman & Hall |location= London |isbn= 978-0-412-28290-4 |chapter-url= http://home.btconnect.com/MalcolmBrown/entries/TOCODYNAMOMETER.html |chapter= Tocodynamometer |access-date= 23 August 2013 |year= 1986 |url-status= live |archive-url= https://web.archive.org/web/20160304044244/http://home.btconnect.com/MalcolmBrown/entries/TOCODYNAMOMETER.html |archive-date= 4 March 2016 }} Online version accessed.</ref>
Monitoring with a cardiotocograph can either be intermittent or continuous.<ref>{{cite journal|title=Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour|url=http://www.cochrane.org/CD006066/PREG_continuous-cardiotocography-ctg-form-electronic-fetal-monitoring-efm-fetal-assessment-during-labour|journal=Cochrane Database of Systematic Reviews|volume=2|pages=CD006066|access-date=6 May 2018|doi=10.1002/14651858.CD006066.pub3|pmid=28157275|pmc=6464257|year=2017|last1=Alfirevic|first1=Zarko|last2=Gyte|first2=Gillian ML|last3=Cuthbert|first3=Anna|last4=Devane|first4=Declan|issue=5|archive-date=7 May 2018|archive-url=https://web.archive.org/web/20180507221407/http://www.cochrane.org/CD006066/PREG_continuous-cardiotocography-ctg-form-electronic-fetal-monitoring-efm-fetal-assessment-during-labour|url-status=live}}</ref> The [[World Health Organization]] (WHO) advises that for healthy women undergoing spontaneous labour continuous cardiotocography is not recommended for assessment of fetal well-being. The WHO states: "In countries and settings where continuous CTG is used defensively to protect against litigation, all stakeholders should be made aware that this practice is not evidence-based and does not improve birth outcomes."<ref>{{cite web|title=WHO recommendations Intrapartum care for a positive childbirth experience (Recommendation 17)|url=http://apps.who.int/iris/bitstream/handle/10665/260178/9789241550215-eng.pdf?sequence=1|website=World Health Organization|access-date=7 May 2018|archive-date=29 March 2018|archive-url=https://web.archive.org/web/20180329081924/http://apps.who.int/iris/bitstream/handle/10665/260178/9789241550215-eng.pdf?sequence=1|url-status=live}}</ref>

A mother's water has to break before internal (invasive) monitoring can be used. More invasive monitoring can involve a [[fetal scalp electrode]] to give an additional measure of fetal heart activity, and/or [[intrauterine pressure catheter]] (IUPC). It can also involve [[fetal scalp pH testing]].{{medical citation needed|date=March 2021}}