57. Fetal Doppler Use in Pregnancy: Pros, Cons, and Limitations for Reassurance

Are you thinking about using a fetal doppler to monitor your baby's heartbeat at home during pregnancy?

Join me in this episode, as we dive further into:

• Pros and cons of using a fetal doppler for increased reassurance…
• Early detection of potential concerns and what to be aware of…
• How dopplers can increase emotional bonding for moms and dads… 
• Understanding the limitations of a doppler and that false reassurance does happen…
• Practical tips for safe and effective doppler use if you choose to monitor at home…
• … and much more!

Tune in to gain insights into the use of fetal dopplers during pregnancy. Whether you're seeking reassurance, considering early detection options, or aiming to deepen your bond with your baby, don't miss this episode of Your Birth Bestie!

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👋 WHO AM I?

Welcome, friends! I am Beth, a certified nurse midwife, doula, and childbirth educator. My philosophy is rooted in autonomy, informed decision making, and positive mindset to help expecting parents plan for a beautiful, stress-free hospital birth. I am here to provide value to YOU through tips and practical advice, either to guide you through pregnancy or to help you prepare for childbirth, postpartum and beyond. There’s no fluff here - only info that adds to your positive experience and saves you stress and uncertainty.

Transcript

Thank you so much for tuning in to Your Birth Bestie Podcast today! You are listening to episode 57 all about using a fetal doppler during pregnancy. We are going to be talking about the pros, cons, and practical tips on using a fetal doppler in pregnancy. Many moms have recently asked me if they should purchase a doppler to listen to baby before their first prenatal appointment, between prenatal visits, or as they get closer to delivery for reassurance. My short answer is no, I don’t think it’s necessary, but I also want to explain my thoughts more about maybe why you would want to, what you should know if you choose to, but also why I don’t recommend it to all moms. I received a good amount of negative feedback the few times I have posted on social media about fetal doppler use in pregnancy, especially from moms that have experienced previous losses and need reassurance, which I promise I will get to in this episode, because like I said my short answer is no I don’t recommend fetal dopplers, but of course it’s not as simple as just that. Nothing is black and white and giving you the info to make the best choice for you is the goal here, so please stick around if you’re interested in this topic. Thank you again for being here and I hope you enjoy this episode!

So let’s first talk about what is a fetal doppler?

A fetal doppler is a handheld ultrasound device that is made to detect and monitor your baby’s heartbeat during pregnancy. It works by using high-frequency sound waves, essentially allowing you to listen to their baby’s heartbeat in the comfort of your home or during one of your prenatal visits at the clinic.

It’s important to monitor baby’s heart rate throughout your pregnancy because it is an indicator of how well your baby is doing and can give information about their health and how they are developing. By regularly listening to your baby’s heartbeat, any concerning changes in the pattern or rate might be able to detect a potential abnormality early on.

So yes it’s important to monitor baby in general throughout your pregnancy, but let’s talk about specifically you monitoring it with a fetal doppler at home.

So first, there are benefits of using a doppler include increased reassurance, early detection of possible concerns, and of course bonding with your baby. 

Probably the most common advantage of using a doppler is the increased reassurance it offers to expectant parents. If you are a mom that is having anxiety in pregnancy or is really worried about loss especially in the first trimester whether you have experienced a previous loss or not, it absolutely can be a stressful time. Being able to hear your baby’s heartbeat can definitely be comforting and get rid of some of those worries and be a reminder for you that baby is doing well. There are parents who listen every day and it becomes part of their routine, making them feel better regardless of the uncertainties of pregnancy. One thing to note, that we will talk about at the end, is to not expect to hear baby’s heartbeat on the doppler until at least 10 weeks, even closer to 12 weeks. 

Beyond the emotional reassurance, I wanted to talk about another benefit which is the early detection of a potential concern about baby. By regularly monitoring baby’s heart rate, you and your provider can identify irregularities or abnormalities that could possibly indicate a problem. It could be a sudden change in heart rate pattern or the absence of movement, these warning signs prompt medical intervention when necessary and wouldn’t be something to assess on your own at home. We will talk about this later too and how there are limitations to reassurance and knowing when to be cautious is important.

There is also the obvious bonding component that can really help parents stay positive and enjoy pregnancy. Listening to the heartbeat with your partner can definitely help both of you become connected to the baby and can also be a way for dads to feel more deeply involved in their baby before birth. 

So yes, there are benefits in using a fetal doppler from providing emotional reassurance and allow for early detection of issues to creating a deeper bond between parents and their unborn baby. Fetal dopplers can possibly play a role in helping expectant families enjoy their pregnancy experience and I definitely think there is a time and place for them, but I also have my reservations and wouldn’t go on recommending it for everyone.

And for that reason, let’s talk about the cons of using a fetal doppler.

One really big concern is the risk of false reassurance that fetal dopplers may provide. You might hear a comforting sound of a steady heartbeat which can mask underlying issues that could lead to a false sense of security. Sometimes a heartbeat that seems normal, may not accurately reflect how baby is really doing. The reassurance parents get could actually delay parents to seek medical attention for genuine concerns that could impact the health of mom or baby. Examples of this are if at the end of your pregnancy, baby isn’t moving as much or something seems off, and parents choose to use the doppler for reassurance. Baby’s heart rate may seem fine to an untrained professional, but there have been times when mom’s heartbeat is mistaken for baby’s and concerns are disregarded or baby’s heart rate seems within the normal range, but it’s not what we would call reactive, potentially a cause for concern. So it’s just an example that there is other assessment pieces that go into just the number on the doppler that it says baby’s heart rate is at that moment. It’s important for parents to not only rely on the doppler of how their baby is doing, but follow up with their provider when there are concerns.

The next point I wanted to make too, is that even though fetal dopplers can help with reassurance, like we just talked about before, they can actually do the opposite and make anxiety worse. This can be from things like having a hard time finding baby’s heartbeat when you’re early in your pregnancy or just in general based on baby’s positioning, or if you notice a difference in their heart rate pattern and think it might be a cause for concern but aren’t sure, it could leave you feeling worried and seeking further reassurance from your OB clinic more regularly than maybe what is necessary, causing anxiety and false alarms, which sounds stressful! It’s just hard because many moms want to use a doppler for reassurance, but then when they use it, they are more worried and sometimes can even be borderline obsessive about checking in on baby multiple times per day, just because they can and just because they want to be sure everything is okay. That seems like a lot to handle honestly and can be avoided by waiting to listen to baby until your prenatal visits and trusting that your body and baby are working together, and not feeling like you need constant checking in on baby. There are probably variations of normal that we don’t even know exist because nobody is monitoring their babies 24/7 for 40 weeks to know. It comes down to being mindful and trusting the process, and also some fear release work here might be helpful for some to let go of that control.

The last piece I wanted to talk about is the concern for potential misuse and misinterpretation of the findings on the doppler because most people are not trained professionals with the training to assess and diagnose an actual concern. Fetal dopplers are made to be a part of prenatal care and should ideally be used under the supervision of healthcare professionals who can provide more information, education, and guidance about what is found. There can be a risk of improper technique, incorrect placement of the toppler, or misreading the fetal heart rate pattern – leading to unnecessary anxiety, misdiagnosis, or false reassurance. This is why I just want to make it a point that parents should always consult with their healthcare providers before using a fetal doppler and to work with them along with recommendations for safe and effective use. If you’re going to use a doppler, it is great if you can voice that to your provider and have them give you tips to ensure safe usage for your situation.

And this leads me to a few practical tips I wanted to briefly mention if you have considered the pros and cons and decide to move forward and use a doppler. It’s completely a personal decision and I’m all for giving moms the information and the options, the benefits and the risks, to make the best choice for them and their family and then supporting them in whatever way I can. I don’t recommend it overall in a general sense, but again there is a time and place and I just want families to feel fully informed to have the best experience.

So the first tip is to be aware of the proper way to use the doppler at home. You’ll want to use a generous amount of ultrasound gel on your belly that helps with the conductivity and reduces friction on your skin with the probe. You’ll then place the doppler probe gently on the lower part of your belly, moving it slowly and slightly changing angles to find the best spot where the heartbeat is the loudest. It may take some time to find the baby's heartbeat which is especially normal in those early stages of pregnancy. So not a reason to freak out, just giving it some time is usually all that is needed. And sometimes you don’t find it just like what happened to me at 10 weeks this pregnancy. My midwife couldn’t find it and I was a little nervous of course, but had to get past the fact that it is common not to yet hear baby at that point. I did have a confirmation ultrasound at 8 weeks and saw and heard the heartbeat then, so had to trust everything was progressing normally. It was no reason to worry, it was out of my control, and there wasn’t anything different I would do from that point than wait for the next appointment to try again.

You also want to know that a normal fetal heart rate is typically between 110 and 160 beats per minute, but can vary depending on how far along you are in your pregnancy and how active baby is at the moment. It is a very fast, rhythmic thumping noise, like a galloping horse, which is important to distinguish from mom’s heart rate which is usually slower, although not always, and is more of a swishing or whooshing sound.

And then if something is outside of the guidelines that you have discussed with your provider after talking with them about at home doppler use, you would want to seek further medical care. General warning signs would be a too fast or too slow heart rate, if you notice baby isn’t moving around like normal, or if you are unable to find baby’s heartbeat. Fetal dopplers are meant to be a tool to supplement prenatal care, not to replace those normal visits, so always follow up even if you are hesitant. Your intuition matters so much and that peace of mind too is helpful in these scary situations.

Thank you so much for tuning in to Your Birth Bestie podcast today. I hope you better understand the pros and cons of using a fetal doppler during pregnancy and agree that they should be used as tools alongside regular prenatal care. It is always my goal for families to feel able to make informed decisions about their prenatal care routine, be at the center of their care, and also feel confident that they are able to have the best experience possible. Thank you again for being here and I will be back with another episode next Tuesday. Bye everyone!