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Why Continuous Fetal Monitoring Can Lead to More Interventions — And What You Can Do Instead


Nearly every woman who gives birth in a U.S. hospital is connected to fetal monitors for the baby’s heartbeat. While fetal monitoring absolutely has an important place in safe birth, the type of monitoring matters — and can deeply affect your experience.


Continuous Monitoring Limits Movement

Continuous fetal monitoring keeps you tethered to machines and often restricts your ability to walk, move freely, use upright or water positions, or shift easily. This restriction of movement matters because labor progresses best when you can move.


Movement helps:

  • open the pelvis

  • use gravity to guide baby downward

  • manage contractions naturally

  • reduce the need for additional interventions


*The challenge: when someone is strapped to a monitor for hours, they lose much of this freedom, which can make labor longer & less comfortable.


What the Latest Evidence Says

A recent New York Times article underscores how routine continuous electronic fetal monitoring (EFM) is used widely — even though decades of research don’t show significant benefit in low-risk labor. The article described continuous monitoring as one of the “worst tests in medicine” because it:


  • does not reliably predict fetal distress.

  • is associated with higher cesarean-section rates, even when babies turn out healthy.

  • tends to be used across nearly all births despite evidence being stronger for more selective use.


So: while monitoring has a role (especially in higher-risk births), when used continuously in a low-risk context it may limit movement without leading to better outcomes — making the balance of risk/benefit shift.


Choose a Provider Who Values Movement


Not all hospitals or clinicians treat monitoring the same. Some rely on continuous monitoring out of habit, concern about liability or workflow, rather than individual risk assessment.


This makes it essential to choose a provider who:

  • Uses intermittent auscultation (listening periodically) when appropriate

  • Allows (and encourages!) upright positions, walking, rocking, swaying, moving about, water use

  • Is flexible and understands that mobility and comfort in labor are just as important as the monitor’s data


Your birth experience is shaped not just by the hospital policy, but the philosophy of the clinician you choose.


Advocacy Is Key — From You or Your Support Team

During labor, you may not feel like advocating for yourself — and that’s exactly why having a doula, birth coach, or informed partner is so powerful.


A supportive birth partner or doula can:

  • Ask when continuous monitoring is being used and whether intermittent monitoring might be appropriate

  • Help you reposition even with belts on to maintain freedom of movement

  • Request removal or adjustment of external monitors when safe

  • Speak up when your body, your comfort, your voice feel ignored


Advocacy isn’t about being “difficult” or distrusting providers; it’s about ensuring your values, goals and body are respected and safe.


Want to Feel More Prepared and Confident?

Your body is designed to give birth — and learning your options makes a world of difference.


If you’d like to learn more about how to prepare for childbirth, sign up for my childbirth education and birth coaching series. I’d love to support you through a calm, confident, well-informed birth.



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