Horses in a Windstorm

A couple of times each day, and longer on some days (or in L & D), the nurses do fetal heart monitoring on the babies. Some biophysicist or medical engineer somewhere is missing a golden opportunity, because a person who could invent better equipment for this task could make a mint and save hours of nursing time.

Literally hours -- they needed to get a 20 minute session on the babies yesterday, and I think it ended up taking at least two hours, three nurses, and an ultrasound machine to get it done. And I'm glad they're following their rules and making sure the babies are healthy, but it strikes me as a little bit of overkill in my case, because 1) the fact that the babies are so squirmy and hard to keep on the monitors is evidence that they're doing well, and 2) as far as I know, the medical problems that have me here (short cervix and contractions) aren't ones that are related to fetal wellbeing (as opposed to some women who are on bedrest for issues like placental problems or fetal growth restriction).

The way they currently do the monitoring is that they have little disks, around the size of hockey pucks but lighter, that pick up the babies' heartbeats. The problem is that the babies move around a lot (and they're small enough at this gestational age that they have a lot of room to move), and so it's hard to keep them on the monitors. Also, the bottom of the monitors are flat, and pregnant bellies are not, so it's hard to keep the monitors in the right place and at the right angle. (For the shorter sessions, the nurses just hold the disks in place; for the longer sessions, they strap them on with elastic bands -- the yellow strips in the picture.) And with twins, they have to find both the babies and make sure they're not getting the same one twice. (They also have to make sure they're not getting my heartrate instead, and apparently I make this difficult because my heart rate is elevated. In fact, I have set off the alarm several times already because my heart rate is too high. Clearly I am not as calm as I may appear.)

The monitors track the heartrates electronically once they're found, but the nurses mostly find them by listening. The audio sounds like a windstorm (all the fetal movement plus my blood flowing), and then the baby heartbeat sounds like horses galloping. It's pretty cool.

It seems that the ideal solution would be to create a wide belt that goes all the way around the belly, and then have a series of microphones (or dopplers or whatever it is that they use) embedded in it. Then you'd need an algorithm to identify heartbeats among the other noise, and once a heartbeat was located, essentially track that heartbeat even if the source moved. Another alternative would be to embed an ultrasound viewer in the monitors, so the nurses could visually see where the babies are rather than just having to guess by sound.