“…In addition, MHR accelerations seen during the second stage with pushing are often longer than fetal accelerations and last the duration of the contraction (Sherman et al, 2002). They also increase in proportion to the strength and pain associated with contractions (Koh et al, 1979). MHR accelerations have been reported that were 60 bpm above the baseline in situations of fetal demise (Herbert et al, 1987;Yamashiro et al, 1988).…”