Chapter 11: Opening – stage 1 of labor
The baby’s heartbeat
Listen to the baby’s heartbeat about 1 time every hour during labor, or more often
if there is a problem. See page 139 to learn how to check the baby’s heartbeat.
The best time to listen to the baby’s heartbeat is soon after a contraction stops.
Listening to the baby’s heartbeat can tell you about his position and health.
Note: If you cannot hear the baby’s heartbeat during a contraction, it
usually does not mean the heart has stopped. It just means the wall of
the womb is thicker during the contraction and hard to hear through,
or that the contraction is moving the baby away from your ear. If you
can hear the baby’s heartbeat immediately after a contraction and it is
normal, it was probably normal during the contraction too.
The baby’s position
Finding the place where the heartbeat is loudest can help you know if the baby is
head down, breech (bottom down), or sideways. See page 135.
The baby’s health
Healthy signs Most babies’ hearts beat between 120 and 160 times a minute during
labor. The heart may speed up or slow down. At times, the heart may be as fast as
180 beats a minute or as slow as 100 beats a minute. If a baby’s heart beats faster
than 180 times a minute or slower than 100 beats a minute, it should quickly come
back to normal at the end of a contraction or with a change in the mother’s position.
Wa r nin g sig ns Baby’s heartbeat is slower than 100 beats a minute or faster than
180 beats a minute.
Slow baby heartbeat — slower than 100 beats a minute,
or slower than 120 beats a minute for several minutes
These things can cause the baby’s heartbeat to drop below 100 beats a minute:
• Cord is very short or is being pinched.
• The baby is not healthy.
• There is not enough amniotic water.
• Placenta does not work well, usually
because the mother has high blood
pressure or the baby is late.
• Placenta is separating from the
• Contractions are too strong.
(This is rare for a normal labor. But
too-strong contractions can easily
happen to a woman who is given
medicines to strengthen labor.)
If you notice that the baby’s heartbeat is slow after a contraction is over but then
goes back to normal, the baby may be having trouble. Listen to several contractions
in a row. If the heartbeat is normal after most other contractions have ended, the
baby is probably OK. Ask the mother to change position to take pressure off the
cord. Listen again after she moves to see if this helps, and keep checking the
baby’s heartbeat often during the rest of labor to see if it slows down again.
A Book for Midwives (2010)