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 is provider approved by the California Board of Registered Nursing, Provider Number 17686, for 8 contact hours, through November 30th, 2025. (This is widely accepted nationwide as continuing education for nurses and midwives. This course is accepted by NARM as Category 1 CE for CPM renewal.)

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

  • By Louise Zook

    “Holly's teaching has changed the way I assess fetal heart rates in labor. This course is so informative, and challenges midwives to the highest standard of assessment practices. Definitely recommend to anyone involved in midwifery and birth work!”

    “Holly's teaching has changed the way I assess fetal heart rates in labor. This course is so informative, and challenges midwives to the highest standard of assessment practices. Definitely recommend to anyone involved in midwifery and birth work!”

    Read Less

Course curriculum

  • 01
    Resources
    Show details
    • How To Use HiveCE
    • Studies and Guidance
    • Fetal Assessment Study Guide
  • 02
    Foundational Concepts
    Show details
    • 1.1 Historical Review and Current Consensus
    • 1.2 The Language of Fetal Assessment
    • 1.3 Review of Relevant Physiology
    • 1.4 Prenatal Preparations for Intrapartum Monitoring
    • Quiz 1
    • Please join the discussion!
  • 03
    Prenatal Considerations
    Show details
    • 2.1 Fetal Oxygenation
    • 2.2 Prelabor Damage
    • 2.3 Auscultated Acceleration Test (AAT)
    • AAT Studies
    • Printable PDF: AAT Form
    • Quiz 2
  • 04
    Intrapartum Fetal Assessment Methods, Standards and Guidelines
    Show details
    • 3.1 Tools for Intrapartum Fetal Assessment
    • 3.2 Death By Hypoxia
    • 3.3 Standards for Intermittant Auscultation in Labor
    • 3.4 Guidelines for Intrapartum FHT Monitoring
    • PDF: Guidelines for FHT Monitoring
    • PDF: 5 second counts vs 6 second counts
    • Audio: FHT recording to be used to practice 5 second counts
    • Quiz 3
  • 05
    Monitoring and Assessment
    Show details
    • 4.1: How To Calculate A Baseline
    • 4.2 Tachycardia and Bradycardia
    • Audio: FHT recording of Bradycardia
    • Audio: FHT recording of Tachycardia
    • Video Q&A: Is baseline a rate or a range?
    • Video Q&A: Relative Tachycardia vs Baseline Change
    • Video Q&A: Special Consideration for Waterbirth
    • 4.3 Arrythmias
    • 4.4 Variation
    • 4.5 Variation Examples
    • Audio: FHT recording of No Variation Counted
    • Printable PDF: Quick Guide Amplitude Chart
    • Quiz 4.2: Variation - approved and in the right place
    • 4.6 Reactivity: Accelerations and Non-reactive
    • 4.7 Decelerations
    • Video Q&A: Can hypertension be a cause of prolonged decels?
    • 4.8 Shifting Research on Variable Decels
    • Audio: FHT Recording of a Variable Deceleration
    • PDF: The 5-60-60-60 Rule for Variable Decels
    • PDF: FHT Reactivity Grid
    • PDF: Factors for FHTs
    • Audio Quiz for Baseline and Variation
    • Quiz 4
  • 06
    Complex Situations
    Show details
    • 5.1 How To Respond To Decelerations
    • 5.2 The Sound of Silence
    • 5.3 Intrauterine Resuscitation
    • Article: Intrauterine Resuscitation During Labor: Review of Current Methods and Supportive Evidence
    • PDF: Things To Try
    • Quiz 5
  • 07
    Evaluating FHTs
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    • 6.1 NICHD FHR Categories
    • 6.2 Reassuring vs Non-Reassuring FHTs in the Community Setting
    • 6.3 FHT Patterns and Commonly Associated Causes
    • Quiz 6
  • 08
    Integration
    Show details
    • 7.1 Charting
    • Video Q&A: Strategies for Monitoring and Charting (while protecting physiologic birth!)
    • PDF: How to Chart FHTs
    • Video Q&A: Anti-Pyretics
    • Video Q&A: Accurary of the Doppler Digital Display
    • FHT Scenario #1: Shonisha
    • FHT Scenario #2: Wendy
    • FHT Scenario #3: Matha
    • Video Q&A: Reminders for Clinical Practice
    • 7.2 Conclusion
  • 09
    Post-Tests and CE Certificates
    Show details
    • MEAC Evaluation Questions
    • Post-test

Course Evaluation Comments

Shared with permission from our

“I am so excited to begin my clinical practice in the mother baby world now, and thanks to this course, I feel much better equipped!”

Christy V

Registered Nurse

“A difficult subject to teach as there is so much information to learn but Holly does a marvelous job!”

Ginger K

Licensed Midwife

“This course was excellent! I learned a lot, and refreshed things I knew already. Thank you!”

Esther S

Licensed Midwife

“This was a wonderful course! Much of the information validated what I already know and how I practice, but I will be implementing positive changes in my practice and how I teach my apprentices. Thank You!”

Louise S

Licensed Midwife

“The teacher was exceptional!!!! I loved how she taught and I learned so much more! I’m glad for all the down loads as I can go over them to keep myself refreshed.”

Rachel T

Direct Entry Midwife

“Very informative, well explained, inclusion of realistic labor scenarios - great class!”

Jamie H

Licensed Midwife

“Love Holly!! So so informative. I learned more about monitoring with this course than I did in school!”

Hayley O

Licensed Midwife

“This was an excellent course to take, I will recommend it to all midwives!”

Debbie S

Certified Professional Midwife

“I’ve loved the course and the way the material was presented. I also love that I can continue to review the information to keep practicing and retaining the new knowledge!”

Participant

Student Midwife

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