Hearing a fetal heartbeat with a Stethoscope

At the end of a random self-talk conversation this morning I remembered how awesome I thought it was when the midwives at the birth center taught me to hear the fetal heartbeat with a stethoscope.  At the time is seemed so hard, and it took me a few tries.  But the more I traveled, the more I realized this method is pretty common in low resource areas.  But in the US where you are likely to learn to listen with a fetoscope or dopler, transferring those skills to a stethoscope will take a few adjustments.

Here are some things I had to learn to master listening with the stethoscope:

  1. It helps if you are already well practiced with a stethoscope.  You need to know how to position it properly in your ears to block out the ambient noise.
  2. You need to already know how to find the baby and identify landmarks.  You will have to position the stethoscope over the back near the head, and there is less room for error than with a doppler.
  3. You need to be willing to press the bell very firmly onto the mother.  You will be pushing hard enough to ‘indent’, and you will leave a red ring (that lasts about 5 minutes) where the bell was pressed against the skin.
  4. You need to already know how to “hear” the heartbeat.  The sounds are different than when you use a doppler, and they are more subtle than with a fetoscope.  One friend equated it to the difference in listening for the blood pressure sounds between an 18 year old healthy young man and a 90 year old lady – the sounds are there, but they are subtle and you need to learn to hear them.

Hope this lists help you master this skill.  If you are just learning how to use a stethoscope and/or to identify fetal parts, it might help to use the stethoscope after you have already found the heartbeat with a doppler. Figure out where you hear it the loudest, and begin your stehoscope search for the heartbeat there.  It may also help to try it on women near term the first few times – it can be easier to identify parts and the fetus is squished right next to the abdominal wall.