Intermittent Fetal Monitoring


This is my sonicaid or fetal Doppler that I use at every antenatal visit and birth. It is gentle, trusted, non intrusive, it’s water proof so you don’t even need to get out of the pool or be disturbed during Labour when we hear the baby’s heart.

Intermittent fetal monitoring means that in active labour I’ll listen every 15 mins, and during the pushing phase every 5 mins – or after each contraction if necessary. When you can move around without restriction it helps you do your thing more easily! Birth is all about movement!

Labour rooms also have these – but you’d have to know about it and ask for this, or have it on your birth plan; “Intermittent Fetal Monitoring please” If you’d prefer to be active and upright during a hospital birth you can ask for this instead of continuous fetal monitoring which is CTG. CTG is often applied as standard to all even though most women are low risk and may not have a medical indication for it. CTG can limit mothers movement during Labour, mothers are strapped with wires to the monitor continuously during Labour and birth, often lying on their back or on their side in bed for greater periods of time.

Continuous fetal monitoring is linked to greater risk of fetal distress and unnecessary cesarean section- which ironically, was the very thing it was designed to prevent.  So feel free to ask for intermittent monitoring and be free to move around!

Scissors or Laser

I did both scissors and laser training so that I could find out which is the best treatment for babies with tongue and lip ties. The scissors is fast, just a few seconds, seems less upsetting for the baby and when done correctly creates a clean and full release of the tight membrane. There is only a few drops of blood if any at all. Parents are present and can sooth and breastfeed their baby immediately.

The laser, specifically the CO2 laser, will release the same membranes well by vaporizing, and has also little to no bleeding. Laser takes longer, and generally parents may not be present during the procedure. Some people think laser will release the tongue tie more ‘deeply’ This is untrue. It is the same tight membrane and fascia released by both scissors and laser, whereas the muscle of the tongue underneath the membrane is not cut as this can damage its function. Both instruments release posterior and anterior tongue ties, and both treat lip ties. Neither treatment requires suturing afterwards.

So, which is best? … I feel both release exceptionally and equally well, however, I think scissors is a better option for babies 0-6 months as it is less invasive, less stressful and still has a great result, especially when followed up with breastfeeding support and gentle mouth exercises.

For older children or for adults with more vascular membranes perhaps laser may be more suitable in order to avoid suturing. The membrane of a baby is thin and does not require any suturing and so scissors is ideal here. For breastfeeding mums, having the support of a lactation consultant is invaluable – I definitely recommend this for more success. In some cases a cranial sacral session will also help in freeing up tension in the body.

There you have it, both laser and scissors are sufficient in treating tongue ties, I believe scissors is a better option for babies 0-6 months and the ‘team’ approach to tongue tie really is best.

For more information see: Tongue Tie Cork

Deirdre O’Leary Vos, RM


10 Things I wish you knew before you give birth

pexels-photo-259363Do not disturb. When birth is undisturbed and the mother feels safe, the body releases hormones that help labour to progress efficiently and also releases endorphins that provide natural pain relief. This also reduces stress and increases feelings of pleasure. However, when birth is disturbed, interrupted or the mother feels unsafe; this causes fear and causes adrenaline to be produced. This increases pain levels, impedes the progression of labour and decreases blood oxygen levels, which can lead to fetal distress and a cascade of interventions

You can say no. Suggestions are just that- you can always say no, and should if that’s how you feel. For example if you would prefer not to have routine vaginal examinations or ARM artificial rupture of membranes. It’s your birth, your say.

Fear leads to meds. Fear often leads to the request of pain medication. It’s not just the mothers that feel fear- partners often experience it too. Pain medication leads to medical management of birth and can increase the rate of complications and interventions.

Birth preparation is key. Birth preparation classes are crucial to an empowering birth. It helps parents to address and release fears, get excited for the birth and feel really well prepared and confident about pregnancy and birth.  I offer two pregnancy and birth preparation classes to all my clients and other expectant parents, in the first and final trimester.

Midwifery-led care is best. Women that use midwifery-led care are less likely to have an epidural, less likely to have an episiotomy, less likely to have an instrumental delivery. They are more likely to have a spontaneous vaginal birth and more birth satisfaction.

Transcend pain. Pain is more manageable when well prepared, e.g. with yoga, breathing techniques, hot shower, birthing pool and a positive, trusted birth companion like a midwife.

Write a birth plan- and go through it with your midwife – it is great to identify roles, goals, intentions and concerns. This helps the midwife to really know what you like and to help you have the most empowering birth. A good midwife knows when to be gently present, when to praise and when to carry.  But just remember above all; you can do this! you totally got this!! write it down, tell yourself daily.

Be active. Humans weren’t made to give birth flat on their backs or with their legs in stirrups  – the pelvic outlet is smaller this way and it’s literally pushing against gravity. We’re meant to move around, lean, lunge, turn, bend, squat, kneel, sit, stand, float, sway, and even dance our way through birth – whatever we need to feel comfortable and help with baby’s descend.

Use a birth pool. The use of a birthing pool significantly reduces levels of pain, leads to a decrease in stress, decrease in length of labour, decrease in perineal trauma, increased relaxation, increased blood oxygen levels and increased feelings of satisfaction. No studies show any evidence of increases in risks or adverse effects. It is safe both to labour and to give birth in water. The baby takes its first breath only after its head is brought up above water. Whether you choose to give birth in water or on land – it’s still an excellent tool to have for pain relief during labour. Many home birth midwives have access to a mobile birthing pool that you can use – just ask about it.

Give yourself the choice. The HSE home birth service is an excellent and free service, available to all healthy, low-risk women. When you apply for the service you will have your own midwife and receive personal one to one care and support throughout your pregnancy, birth and for two weeks after. You can still choose at any moment, where to give birth  – even during labour. You should give birth where you feel safest – whether that is in a hospital or at home -sometimes you only really know for sure when you have contractions. Your midwife will happily support you and stay with you throughout. Best wishes for your pregnancy and birth.

Deirdre O’Leary Vos- Midwife