The phrase biophysical profile might sound fancy — and maybe even scary at the same time. This phrase is not as common when discussing pregnancy as some others, mostly because not every expectant parent will have this experience.

At Magnolia, we are committed to educating and preparing our birthing parents. Did you know that half of first-time parents birth their babies by 40 weeks and 5 days, while 75 percent of first-time parents deliver by 41 weeks and 2 days? This means that the majority of people who are pregnant with their first full-term baby will go past their due date. When that happens as a birth center client, a biophysical profile is necessary to make sure the baby is thriving.

We want you and your support people to understand all screenings and assessments thoroughly. That’s why, in this blog, we’re exploring the biophysical profile, a mandatory assessment if you remain pregnant after 40 weeks.

What is a Biophysical Profile?

A biophysical profile (BPP) is a non-invasive assessment of fetal well-being after 40 weeks. It measures five components, and it consists of two parts, including a cardiotocography (CTG), more commonly known as a nonstress test, and an ultrasound.

A typical BPP takes approximately 30 minutes, can be performed at any time of the day or night, and does not require any preparation. There is a scoring system based on the collective test result, with the highest score being a ten. The purpose of this test is to help determine if the baby is receiving enough oxygen and if they are in any distress. A BPP occurs in a certified facility, and we will refer you for the assessment if it’s needed.

Part 1: What is a CTG/Nonstress Test?

As the name suggests, no stress is placed on the baby during a nonstress test. An electronic fetal monitor measures the fetal heart rate and uterine contractions while the pregnant person is comfortably sitting or lying down. Two elastic belts with electronic sensors are placed around the person’s abdomen while both fetal heart rate and uterine contractions are measured and recorded. The CTG itself is one of the five components to the BPP. For a reactive result, the score is two points, meaning there’s a finding of two or more accelerations of the fetal heart rate in 30 minutes.

If there are less than two movements in 30 minutes, the fetus may be sleeping. In that case, medical staff may use a loud sound, such as a buzzer, to awaken the baby and stimulate movement.

Part 2: What is a Biophysical Ultrasound?

A device called a transducer is gently placed on the abdomen. This produces sound waves that echo off the internal structures of the body. The transducer converts these echoes to images that are then viewed on a monitor screen. During the ultrasound, the remaining four components of the BPP are assessed, and each is worth two points. These include:

• Fetal breathing movements: Looking for one or more breathing movements lasting longer than 30 seconds in 30 minutes.

• Fetal tone: Observing one or more fetal extremity extensions or flexions, such as a nod of the neck or an open and close of the fetal hand in 30 minutes.

• Gross body movements: Watching for three or more body or leg movements in 30 minutes.

• Volume of amniotic fluid: Examining for a single deep pocket of amniotic fluid measuring greater than two centimeters.

Why is a Biophysical Profile Important?

For Magnolia clients, biophysical profiles start around 40 weeks, 3 days and occur twice a week until 42 weeks. If you reach 42 weeks, you will be scheduled for a medical hospital induction.

Because Magnolia is licensed by the State of Florida, we are required to follow the Department of Health's protocols, and the post-dates biophysical profile is one of them. If you want to deliver at Magnolia and you go past 40 weeks, BPPs are not optional. This is how we keep you in our care, ensure both you and your baby's safety, and meet the guidelines of Florida’s laws and regulations on how birth centers operate. The benefits of BPP are evidence-based, and we rely on that evidence to guide our safe practices.

What Do the Results of my BPP Mean?

Following your biophysical profile, you will receive your score, which is a number between 0 and 10.

• A score of 8 to 10 is considered normal and suggests the risk of fetal distress is extremely low.

• A total of 6 is deemed abnormal and could indicate a repeat BPP in 24-48 hours, additional monitoring, or an induction of labor depending on what specific results were obtained.

• A rating of 2 to 4 is not reassuring, and imminent delivery is recommended.

• A score of 0 indicates a severe lack of oxygen/gas exchange to the fetus and urgent delivery should be performed, typically by cesarean section at a hospital best equipped with a Neonatal Intensive Care Unit.

It’s important to note that Magnolia clients can still give birth at the birth center up until 42 weeks if BPPs are within normal limits, per Florida birth center law.

Miami’s Premier Natural Birthing Center – Prenatal Care and Birth Services in Miami

At Magnolia, we strive to take away the uncertainties that can come with pregnancy and childbirth in a variety of ways. If you are interested in learning more about prenatal care and birthing services, call us at 786-953-6534 or fill out our form to set up a free consultation.