In this dynamic course, Holly dissects the complex tangle of fetal assessment, and translates the latest recommendations of ACOG along with the original consensus of the National Institutes of Child Health and Human Development (NICHD), to create recommendations specific to the out-of-hospital setting, and in accordance with the Biodynamic model of midwifery.

The 3rd edition contains updates to content, along with interactive exercises using audio recordings of FHTs, and written scenarios.




Upon completion of this course, the learner will be able to:

1. List six factors needed for maternal-fetal transfer of oxygen, carbon dioxide, nutrients, etc.
2. Discuss two features of fetal circulation that reduce risk of fetal hypoxia
3. List four factors used in assessing fetal well-being in labor
4. Describe how the fetus responds to catecholamines (stress hormones)
5. List potential fetal stressors
6. Describe what conditions lead to “primary apnea” and then to “secondary apnea”




This course was originally intended for those attending birth in homes and birth centers. 

The information in this course is equally useful to any care provider utilizing handheld Doppler for intrapartum fetal monitoring, in any setting.




HiveCE is an approved provider of continuing education by the California Board of Nursing, and this course meets the California Board of Nursing criteria for 8 hours of continuing education. Provider approved by the California Board of Registered Nursing, Provider Number 17686, for 8 contact hours. (This is widely accepted nationwide as continuing education for nurses and midwives.)

This course has been approved by MEAC for 8 contact hours of continuing education through September 30, 2025. Approval ID: M2223-86-0901DE

Approved for the NARM Midwifery Bridge Certificate, Category 2.

This course meets the criteria for the Utah midwifery licensing requirement of a course in "intrapartum fetal monitoring."


Note: Course completion does not authorize the learner to use skills outside their scope. Please refer to your state guidelines for determining scope of care.

For information regarding our refund policy and other Frequently Asked Questions, please refer to our FAQ. If you have additional questions, please email [email protected].

  • Instructor(s)

    Instructor Bio:

    Holly Scholles, MA, CPM, is a homebirth midwife with over 40 years of experience, and was the founder and president of Birthingway College of Midwifery. She is also an anthropologist specializing in human reproduction and medical anthropology.

    Holly Scholles

    MA, CPM

On-Demand Access

Take the course, print your CE certificate, retain access for later reference.

Bundle with Better Charting for Midwives and save $30!

Better Charting for Midwives + Fetal Assessment in Labor = 10 hours MEAC approved CE

Reviews from earlier editions...

  • By Erin Reynoso

    “I am so grateful for this course and have recommended it many times. I was trained in the late 1990s and we just listened to heart rates. This course taught get me to read patterns. I'm so grateful I didn't have a fatality of a baby before learnin...”

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    “I am so grateful for this course and have recommended it many times. I was trained in the late 1990s and we just listened to heart rates. This course taught get me to read patterns. I'm so grateful I didn't have a fatality of a baby before learning this. And I'm SO grateful to know this information. Thank you!!!”

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  • By Joanne Estmalek

    “Thank you for your great course! It was a good review of information that all midwives should know as well as a good opportunity to catch up on new recommendations and research. ”

    “Thank you for your great course! It was a good review of information that all midwives should know as well as a good opportunity to catch up on new recommendations and research. ”

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  • By Jami Morris

    “I learned so much from this class. It truly shows the importance of 5 second counting while monitoring the fetus. I also enjoyed the topics on accelerations, decelerations, and variables. I appreciated the review on the Category I, II, and III...”

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    “I learned so much from this class. It truly shows the importance of 5 second counting while monitoring the fetus. I also enjoyed the topics on accelerations, decelerations, and variables. I appreciated the review on the Category I, II, and III FHR patterns. One of the most interesting points for me was the description of what the fetus experiences during the conditions that lead up to primary and secondary apnea in utero. I appreciated the spirit in which Holly taught this course as well as her in-depth knowledge of the subject matter. ”

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  • By Yolanda Visser

    “Great information laid out in an order that makes sense to someone taking the webinar. Invaluable for the starting midwife and challenging for those of us that have been around a long time. Information to add to our base and ideas to help us rethi...”

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    “Great information laid out in an order that makes sense to someone taking the webinar. Invaluable for the starting midwife and challenging for those of us that have been around a long time. Information to add to our base and ideas to help us rethink what we know. Only by growth can we better ourselves in servicing mothers and babies. This course lends to that goal.”

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  • By Susan Struble, LM

    “There was an amazing amount of material in this course and I felt it was very beneficial. I am going to have to work quite a bit on the 5 second count to become proficient at it. It was new to me and quite helpful. I also had not heard the info...”

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    “There was an amazing amount of material in this course and I felt it was very beneficial. I am going to have to work quite a bit on the 5 second count to become proficient at it. It was new to me and quite helpful. I also had not heard the information on scalp stimulation for a depressed infant, so I am going to research that some more.”

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  • By Judith Schmidt

    “very informative very intense”

    “very informative very intense”

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  • By Jocelyn Brown

    “Holly rocks as usual. Learned tons of practical information. Now have new skills and new ways of charting and expressing my reassurance and concerns during prenatal care and in labor. Some frustration with quizzes and end test feeling occasionally...”

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    “Holly rocks as usual. Learned tons of practical information. Now have new skills and new ways of charting and expressing my reassurance and concerns during prenatal care and in labor. Some frustration with quizzes and end test feeling occasionally inconsistent with information learned, but this is not a reflection of the overall quality of the workshop. Jocelyn - Based on feedback, we looked at the aggregate data on ProProfs and removed any questions that a significant number of students got "wrong." Thanks for bringing our attention to this issue! ~ Jesica”

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  • By Chelsea Campbell

    “I highly recommend this class for updated information on FHT assessment. Holly Scholles was clear and enjoyable to listen to. My only complaint with the test is that, with current discrepancies (particularly surrounding early decels vs. variable d...”

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    “I highly recommend this class for updated information on FHT assessment. Holly Scholles was clear and enjoyable to listen to. My only complaint with the test is that, with current discrepancies (particularly surrounding early decels vs. variable decels), the test questions were at times confusing. It was hard to tell upon which information they were based upon. The material was clear for practice, though. Chelsea - Thanks for the review! We went through the post-test a couple months ago and removed any test questions that a large percentage users were having trouble with, based on their responses on ProProfs (we can see aggregate stats per question). Did you take the test more recently, or was it perhaps prior to that change? If it was recently, please email us to let us know which test questions you found confusing, so we can take a look at them and either edit them or remove them. Thank you! ~ Jesica ”

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  • By Mary Earhart Unger

    “Thank you! I needed a refresher and learned some new stuff! Definitely a help in my clinical and homebirth practice.”

    “Thank you! I needed a refresher and learned some new stuff! Definitely a help in my clinical and homebirth practice.”

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  • By Alexandra Wagner

    “I found that I am clearly out of practice in taking tests. So there was a lesson in itself: after 12 years I need to brush up on study skills. Definitely gathered some very valuable new information and will incorporate the 5 second ct in my assess...”

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    “I found that I am clearly out of practice in taking tests. So there was a lesson in itself: after 12 years I need to brush up on study skills. Definitely gathered some very valuable new information and will incorporate the 5 second ct in my assessments. Thank you !”

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  • By Susan Meeks

    “The class was very thorough and well taught. Thanks so much!”

    “The class was very thorough and well taught. Thanks so much!”

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  • By Sally Acosta

    “This workshop was extremely informative for me. I have been a busy midwife for 5 years and thought this would be a review for me. It was not a review, I learned completely new information. I also had my students take the course and they benifited ...”

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    “This workshop was extremely informative for me. I have been a busy midwife for 5 years and thought this would be a review for me. It was not a review, I learned completely new information. I also had my students take the course and they benifited greatly. We are actually changing our protocols for FHT assessment during labor. I truly enjoyed this class and the PDFs provided are very helpful. ”

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