Why shouldn’t I use a Home Doppler for reassurance?

Home dopplers and phone apps are becoming increasingly common, but many aren’t aware of the dangers of using them for reassurance when they are concerned about their baby.

If you are worried about your baby’s movements it is important to be monitored by a CTG or a midwife who can interpret the baby’s heartbeat. 

Another way to think of it is this – if you saw a person in the street showing symptoms of a stroke or fainting would you delay phoning an ambulance because they still had a heartbeat?

It’s also vital to remember that it takes midwives and doctors many years to learn how to interpret what they hear when they listen to a baby with a doppler.  Not only can it be really tricky to differentiate between the baby’s heartbeat, mums heartbeat and other sounds such as noise from the placenta, they also listen for abnormalities such as decelerations.  The presence of a heartbeat alone does not always indicate that all is well.

Always speak to a midwife if you have any concerns about your baby, you are not being a nuisance, you’re looking after your little one!

The dangers of home fetal heart monitoring: a personal perspective on the home doppler

British Medical Journal Amy L Blake, CT1 Psychiatry

The Caludon Centre, Clifford Bridge Road, Coventry, CV2 2TE

17 November 2009

Home DopplerAs a junior doctor currently experiencing a complicated pregnancy first hand, I read Abhijot Chakladar and Hazel Adams’ article[1] with unease. A few weeks ago, in a state of significant anxiety about my baby’s health, and before I could feel any fetal movements, I seriously researched buying or hiring a fetal heart monitor in the hope that being able to hear my baby’s heartbeat might allay my fears between visits to the hospital and midwife.

Thankfully, I can still remember my brief training in basic midwifery from medical school and the difficulty I had in reliably detecting anything at all with a fetal Doppler, let alone differentiating between fetal and placental blood flow, and so thought better of it. A close friend of mine however, had only the experience of watching her midwife confidently detecting the baby’s heart beat at each consultation. She purchased an amplifying system and has, I am convinced, been contentedly listening to her placenta for the last 6 weeks.

On the night I was trawling the internet, I was struggling to decide whether my PV bleeding warranted presenting to hospital. If I had had a Doppler at home and could have heard the heart beat I would probably not, as I later did, have called my consultant and been admitted.

The marketing of these devices for the use of untrained individuals is a recipe for disaster. At one end of the spectrum, individuals who are unable to detect anything resembling a fetal heartbeat will flood midwifery clinics and emergency departments unnecessarily. More worrying, however, at the other extreme, is the tragic case described by Chakladar and Adams, where false reassurance through improper interpretation of these sounds results in delayed presentation and, possibly, a still birth and lifetime of guilt for the parent.

Pregnant women see these devices being used in clinics at every appointment as a marker of fetal wellbeing. I do not feel that any amount of emphasis on the part of the manufacturers that they are not meant as a substitute for normal antenatal care will suffice. Midwives and obstetricians need to become increasingly aware of the wide availability of fetal heart monitors and counsel all couples, particularly those experiencing complications, against their use.