The Case Against Continuous Fetal Monitoring: Why It's Not Always Recommended

Continuous fetal monitoring during labor has been a standard practice in many hospitals for decades, but recent research and evolving guidelines have raised questions about its routine use. Here are compelling reasons why continuous fetal monitoring may not always be recommended:

1.     Increased Intervention Rates: Continuous fetal monitoring has been associated with higher rates of interventions, including cesarean sections and instrumental vaginal deliveries. This is often due to false alarms or non-reassuring readings that prompt medical interventions unnecessarily.

2.     Limited Evidence of Benefit: Despite widespread use, studies have not conclusively demonstrated significant improvements in perinatal outcomes with continuous fetal monitoring compared to intermittent monitoring. Intermittent monitoring, where the baby's heartbeat is checked at intervals, may be just as effective in many low-risk pregnancies.

3.     Reduced Mobility and Comfort: Continuous fetal monitoring typically requires the use of belts or electrodes strapped to the mother's abdomen, limiting her mobility during labor. This can impact comfort and potentially prolong labor.

4.     Potential for False Alarms: Continuous monitoring can lead to increased anxiety for expectant parents and healthcare providers due to frequent false alarms or minor variations in fetal heart rate that do not necessarily indicate fetal distress.

5.     Preference for Individualized Care: The optimal approach to fetal monitoring may vary depending on the specific circumstances of each pregnancy. Some low-risk pregnancies may benefit from intermittent monitoring or other non-invasive techniques that allow for greater mobility and reduce unnecessary interventions.

It's important for expecting parents to discuss fetal monitoring options with their healthcare providers and explore personalized approaches to labor and delivery. Shared decision-making based on individual risk factors, preferences, and evidence-based practices can lead to better outcomes and a more positive childbirth experience. Continuous fetal monitoring should be considered judiciously, with careful consideration of its potential benefits and drawbacks in each unique situation.

Additional information

https://journals.sagepub.com/doi/pdf/10.1177/0883073814543306