Home Fetal Heart Monitors: A Hoax?
Posted by realityrounds on November 8, 2009
Do you know anyone who has used a home fetal heart monitor? For some reason, they make me uncomfortable, and the authors in a recent BMJ article feel the same. A home fetal heart monitor can be bought over the counter or on the internet, and it is meant to be used for “entertainment” purposes only. However, my suspicion is that the women who are buying and using them, are using them for reassurance reasons. They want to be reassured that everything is OK with their baby. They want peace of mind. This is totally understandable. I fell into this same trap with my first pregnancy. I wrote a post awhile back about how I was ultrasound addicted with my first pregnancy, and would scan myself at work every chance I could get. But really, scanning yourself constantly at work, or using a home fetal heart monitor does not offer real “reassurance” or even guarantee the health status of the baby.
The BMJ commentary explains the case of a mom who at 38 weeks, delayed a visit to her doctor because she was reassured everything was OK because she heard her infant’s heart rate on the home monitor. Tragically, the infant had died in utero and the mom was actually listening to her own heart beat, not the baby’s. These are the cases I worry about when we take medical technology and sell it for home use, and just for “entertainment” purposes. Companies that sell these monitors explain how the monitors can help you bond with your baby, and reassure you that your baby is “happy and safe.” Do we really think a heart monitor can do that? The cynical side of me does not believe a piece of machinery can help you bond more with your baby. The cynically part of me does not see how hearing the fetal heart rate can reassure you that you have a “happy” fetus.
The not-so-cynical part of me however, understands that if you had trouble getting pregnant, or suffered from miscarriages, listening to that fetal heart rate can mean a lot. You may be afraid of bonding and suffering more pain from a loss. Hearing the baby’s heart rate may give real peace of mind. But, I also think, like the BMJ article addresses, that a home fetal heart monitor may offer a false sense of security, and actually cause more anxiety if the mom can not pick up the fetal heart rate.
As far as I know, there have been no studies on the use of these home fetal heart monitors, as it relates to the psychology of why a mom would use one. I also have no idea how widespread the use of these machines are. They just give me an uneasy feeling, which most likely is unwarranted, but that is just how I feel.
How do you feel about them?
RR
darlene said
I’m with you, RR. I think no good can come of encouraging women to distrust their own bodies and intuition and instead rely on technology. It worries me when I hear women talk about frequent ultrasounds, or their reliance on u/s as their only source of peace of mind during their pregnancy. Too often, the same women who speak to me of such a reliance end up scheduling c-sections prior to their EDD, saying they feel “safer” having expert surgeons take care of the delivery of the baby, rather than birthing vaginally themselves.
I fear that the more we rely on machinery during our pregnancies, the more disconnected from our pregnancies we will become, and the more we will distrust our own body’s ability to birth. Certainly, technology is useful and extremely valuable, but current maternal mortality and morbidity rates and various studies have demonstrated that technology is only as useful as our discrimination in using it.
Rixa said
I used a fetoscope a lot during my two pregnancies. I really enjoyed using it, because I could figure out where things were (it helped me pinpoint the baby’s position and, at least with Zari, the location of the placenta). I enjoyed listening to the heartbeat and just developing good-old auscultation skills. I had a lot of anxiety with Dio–diffuse, nothing specific really–and it was really reassuring to me to be able to listen to his heart whenever I wanted to. He had lots of variability, which I could easily pick up with my musician’s ear (was a violin performance major in college my first year…) One nice thing about using a fetoscope vs. doppler is that it’s a lot harder to mistake fetal for maternal heart beats. They sound totally different with a fetoscope. I didn’t feel that my fetoscope somehow kept my baby safe, but it was nice to be able to take a listen. It felt on the same level as when I’d feel my belly and poke around trying to figure out the baby’s position and enjoy feeling the baby kicking back.
pinky said
I was also going to point out the fetoscope. Also you can take your own pulse when you listen to your baby. If it is on the market, women will now be using them. Just telling them no isn’t going to work.
Ciarin said
These things have been on the market for awhile. When women ask me about them, I discourage them from buying the stupid things for the very reasons that RR mentioned in the post – false sense of security or anxiety at not being able to find the heartbeat.
Jenna said
Interesting reason to be against the doppler renting trend. I am as well, although I was having a hard time pinning down why until I read comment #1. I’ve actually found that I don’t like hearing the baby’s heartbeat because the moment where the midwife is looking feels like hours and I would rather not go through that over and over, especially unnecessarily.
MomTFH said
I have a good friend who is a medical student, and his wife is pregnant. She bought a doppler to use at home. It was apparently against his wishes, and was something they argued about. I remember first learning to use it when I was training as a midwife, and it was hard to get the hang of. I was a lot less emotionally vested in finding those fetal heart tones than a mother to be, and it was frustrating.
Rixa – I’ve seen a fetoscope, but I haven’t used one. It looks like it would be difficult to use on yourself. Did you have to contort yourself to use it?
Jessica said
I think that people will inevitably use this ‘entertainment’ device as a self-diagnosis tool. In the hands of most that will give them either a false of security or a false sense of worry (better run to the ER because I can’t find the heartbeat). Coming from a first pregnancy where my baby was very sedate, however, I can see the appeal. In the last trimester every source (OB, midwife, books, friends etc) say to do the ‘kick count’ to make sure the baby is doing well. My little one MIGHT have been active for 5 min in the morning and 5 min at night, and even massage, loud noise, food etc rarely solicited movement from him. He was fine, just very sedate. I think the post about using a fetoscope to listen to a hearttone is a good idea for woman who want such a thing. Using a machine is just asking for trouble.
Rixa said
If you get a fetoscope with 22″ tubing, rather than 7″, it’s easy to use yourself. I held the forehead rest with my hand, touching it as little as possible so I wouldn’t get sound interference. The tubing was plenty long to reach to my ears. No contortions needed.
Kathy said
I picked up one version of a fetal monitoring device when I was pregnant with my first child (it was at a yard sale for $1 — I couldn’t resist!). I never really could hear his heartbeat well, though, which is what a lot of people complained about when I looked up reviews for the particular model (I think it originally sold for something like $20-30, so it’s not like it was a high-end Doppler or anything). But what it *did* do, was every time I put the device on my belly, my son would kick. And there was at least one time when I hadn’t felt him for a while, which was unusual, and I pressed the thing to my belly, and then finally he kicked it. So that reassured me.
I’m pretty sure I could also have just pushed on my abdomen with my hand and gotten the same response — but sometimes I could occasionally pick up his heartbeat. I never used it during my second pregnancy.
Ciarin said
‘Real’ dopplers run about 700-800 dollars. Yet another reason why I tell women not to waste $30-40 :p
Whitney said
I rented a Doppler with my first pregnancy after I had a bout of spotting on a Saturday morning and couldn’t see the doc until Monday morning. The spotting wasn’t enough to justify going to the ER, but I was terrified nonetheless and spent a horrible weekend wondering if my baby was okay. I was later diagnosed with marginal placenta previa. Anyway, I didn’t want to go through that uncertainty again. I had no problem finding the heartbeat or discerning it from my own. I didn’t use it frequently and returned the Doppler before I delivered because my husband was actually able to hear the heartbeat simply by pressing his ear against my belly.
I’m 37 weeks into my 2nd pregnancy and have not used a Doppler this go around. My doc does a very quick u/s at every visit using an ancient u/s (lower exposure than newer machines and less exposure than a Doppler) so I don’t feel the need for further reassurance.
BTW, I know the regular u/s sounds like I’ve got an interventionist doc, but paradoxically, he’s THE VBAC doc in Atlanta and has a c-section rate of 10-15%. He’s the only one around who will do VBAmC and breech vaginal deliveries (if his in-office ECV doesn’t work) and he doesn’t give a hoot about projected birth weights. Too bad all docs can’t use u/s technology for “good” (quickly checking fluid levels, heartbeat and guiding ECV) instead of evil (finding reasons to induce/cut)!
JHolmes said
I’m going to out myself as a mom who bought a doppler back in 2004, and for me? It has been a Godsend. I’m in my 9th pregnancy, but it’s only my 5th going to term, and I’ve had a missed miscarriage where I had no idea anything was wrong until I went for a routine ultrasound and found out that my babies had died weeks earlier and I knew nothing. While waiting for my D&C I knew my babies had died, and I still had morning sickness and was in maternity clothes. It was horrible. That loss in particular really made it difficult for me to just trust that if I’m not bleeding or cramping, I should just trust that everything is fine.
I got the doppler because the worry just isn’t worth it to me and I don’t want to be the crazy lady heading over to my midwife’s every time I start getting very worried just because it’s too early to feel movement. I can’t imagine the anxiety is a good thing for my baby or babies either, and I can tell pretty easily between my heart rate and a fetal heart rate. I also don’t doppler really at all once I have movement going on and maybe listen twice a month or so before quickening, but for that time when morning sickness is perhaps going away and you can’t feel movement yet and the doubt and worry can creep in? It can be very very helpful psychologically as long as you understand that it is a tool with specific limitations and that you may get information that is bad. If I was concerned for a specific reason, though, I shouldn’t be dopplering myself but talking to my midwife, *especially* later in pregnancy. But if you tend towards slight paranoia after you’ve been burned pregnancy wise before and will be reasonable about things, I think it can be a good option.
pinky said
After reading all the comments I am begining to think that owning a doppler while pregnant is similar to buying an oxygen sat monitor when you have a breathing problem. My Dad’s doctor told him “DO NOT BUY AN O2 SAT MONTOR” So for his birthday he asked for one. But I think in his particular case, it made him more reassured than crazy. He would look at his o2 sat, see that it was Ok and then he would accept it and go to sleep. Otherwise he would sit awake worrying that he would die in his sleep. Poor guy! Same with the doppler. Some women are going to make themselves crazy with it and some are going to feel more reassured. I guess it is going to depend on who you are personally and how your mind operates.
paula said
I rented a doppler while pregnant with DS. He came after a preemie and 4 miscarriages, so I was a nervous wreck the whole 39 weeks. Obviously the doppler was no help with my fear of another preemie, but it gave me much needed reassurance in between doctor visits. My OB knew I had the machine at home, and was in favor of anything that kept me calm. I sent it back about 27-28 weeks, by which time I was confident enough to pay attention to DS’s movements.
Christa said
Easy to say Darlene….it’s easy to say, until you have had 5 miscarriages. I have had 5 live births, 2 natural, un-medicated, vaginal births. 1 necessary 35 week breech triplet cesarean birth…. and 5 miscarriages ranging from 6 weeks along to a 13 week gruesome miscarriage that resulted an a horrible D & E and a terrible infection, because we all thought the pregnancy was going fine….I went in on a gut instinct that something was wrong and asked for an ultrasound…..
sometimes, just SOMETIMES, technology is GREAT. Sometimes our bodies *don’t* get it right, and that’s when our *INTUITION* kicks in.
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