Tech or Touch? Women’s Experiences with Fetal Heart Monitoring During Labor, study finds

Recebntly published comprehensive analysis of women's experiences with various fetal heart rate monitoring technologies during labor was conducted through a national survey of 861 Australian women who gave birth within the previous five years. The study aimed to evaluate the impact of different fetal monitoring techniques on labor experiences, perceived benefits, and risks, highlighting the significant differences based on monitoring type, parity, place of birth, and pain management strategies.

Findings on Fetal Monitoring Methods

Results revealed that continuous electronic fetal monitoring (EFM) via wired cardiotocography (CTG) was the most commonly used method, especially among primiparous women in private hospitals. Women who experienced wired CTG monitoring were significantly more likely to report negative perceptions regarding its impact on their labor experience compared to those using intermittent handheld devices or wireless telemetry. In particular, those monitored via wired CTG had an increased likelihood of requiring pharmacological pain relief methods, including epidurals and nitrous oxide, while those with handheld monitoring reported higher engagement in non-pharmacological techniques and greater bodily freedom, which positively affected their pain management and control during labor.

Disparities Based on Place of Birth

The analysis indicated significant disparities in monitoring types based on the place of birth. Private hospitals demonstrated a higher reliance on wired CTG, while birth centers leaned towards using handheld Doppler monitoring, indicating an obstetric-led care culture that emphasizes continuous monitoring. This reliance on wired EFM was associated with an increased incidence of emergency cesarean sections, suggesting a potential correlation between monitoring type, intervention rates, and women's autonomy during labor.

Barriers to Wireless Monitoring Technologies

Additionally, the study highlighted systemic barriers to the adoption of wireless monitoring technologies, despite their availability since 2003. A cultural resistance within hospital settings, limited equipment availability, and staffing constraints contribute to the continued use of more intrusive monitoring methods, thereby impacting women's labor experiences negatively. Women reported feeling "tethered" during labor, highlighting the need for a shift toward practices that prioritize women's autonomy and comfort.

Implications for Hospitals and Policymakers

This research underscores the necessity for hospitals and policymakers to critically evaluate fetal monitoring guidelines and resource allocation, emphasizing the benefit of less invasive monitoring options. The evidence indicates that increasing access to continuity of care models and investing in supportive care can lead to better maternal outcomes, enhanced satisfaction, and more positive birth experiences for women, especially those at lower risk. Implementing these changes is essential for moving towards humanized childbirth practices.

Key Points

- A national survey involving 861 Australian women revealed significant variations in their experiences with fetal heart rate monitoring technologies during labor, particularly influenced by monitoring type, parity, birth location, and pain management strategies.

- Continuous electronic fetal monitoring (EFM) through wired cardiotocography (CTG) was predominantly used, especially among first-time mothers in private hospitals. Women using wired CTG reported more negative labor experiences and a higher reliance on pharmacological pain relief compared to those utilizing intermittent handheld devices or wireless telemetry.

- There were notable disparities in monitoring practices based on the place of birth; private hospitals favored wired CTG, while birth centers preferred handheld Doppler monitors. This pattern suggests a more obstetric-led care approach in hospitals, which could correlate with higher intervention rates, such as emergency cesarean sections, potentially limiting women’s autonomy during labor.

- Systemic barriers such as cultural resistance in hospital environments, limited availability of wireless monitoring equipment, and staffing issues contribute to the persistent use of invasive monitoring methods. Many women expressed feeling "tethered" during labor, indicating a need for practices that enhance women's autonomy and comfort.

- Findings indicate a pressing need for hospitals and policymakers to reevaluate fetal monitoring guidelines, advocating for less invasive options to improve women's labor experiences, satisfaction, and overall maternal outcomes.

- Improved access to continuity of care models and investment in supportive care are recommended as strategies to foster humanized childbirth practices, particularly for women at lower risk.

Reference –

Kate M. Levett et al. (2025). Differences In Women’S Experiences Of Labour According To Type Of Fetal Monitoring: A Quantitative Analysis Of An Australian National Survey. *BMC Pregnancy And Childbirth*, 25. https://doi.org/10.1186/s12884-025-07509-z.