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Evidence Library · Monitoring

What continuous monitoring does, and what it costs

It halves newborn seizures. It has never been shown to prevent cerebral palsy. It raises your chance of an operation.

Almost every American hospital straps two sensors to your abdomen and records the baby's heart rate continuously. Across 13 trials and more than 37,000 women, compared with a midwife or nurse listening at intervals:

OutcomeEffect of continuous monitoring
Newborn seizuresAbout half as many (relative risk 0.50)
Cerebral palsyNo difference (relative risk 1.75, not significant)
Death around birthNo difference (relative risk 0.86, not significant)
Cesarean delivery63% more (relative risk 1.63)
Forceps or vacuum15% more (relative risk 1.15)
The trade, stated plainlyFewer seizures. No proven reduction in cerebral palsy or death. Substantially more operations. Almost nobody is told the third line, and intermittent listening is rarely offered as the alternative it is.
Where this comes from:
179. Alfirevic Z, Devane D, Gyte GML, Cuthbert A. Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour. Cochrane Database Syst Rev. 2017;(2):CD006066.

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