Electronic Fetal Monitoring in Labor: Pros and Cons (What the Research Really Says)
At Our BirthRoom®, Stephen and I often remind expectant parents:
“It takes a long time for medicine to catch up to the science.”
And nowhere is that more clear than with electronic fetal monitoring.
Recently, a New York Times article brought national attention to something many birth professionals have been discussing for years:
One of the most common tools used in labor may not be improving outcomes the way we once hoped.
If you’re planning a hospital birth, this is something worth understanding—because it can shape your entire experience.
What Is Electronic Fetal Monitoring?
Electronic fetal monitoring (EFM) is a tool used during labor to track:
your baby’s heart rate
your contractions
It’s typically done using belts placed around your abdomen and connected to a machine.
It was created with good intentions and to detect when a baby might be in distress.
And in certain situations, it can be incredibly helpful.
But here’s where things get more nuanced.
The Pros and Cons of Electronic Fetal Monitoring
Let’s look at both sides—because this isn’t about fear.
It’s about informed decisions.
When EFM Can Be Helpful
In higher-risk situations, continuous monitoring can:
• help providers track how baby is tolerating labor
• identify potential concerns earlier
• guide medical decision-making
This might include:
• certain high-risk pregnancies
• inductions using medications like Pitocin
• known complications with baby or placenta
In these cases—monitoring can be an important tool.
What the Research Shows
For low-risk pregnancies, decades of research consistently show:
• no reduction in cerebral palsy
• no reduction in newborn death
• no improvement in long-term outcomes
But what does change?
intervention rates
Continuous electronic fetal monitoring is associated with:
• higher rates of cesarean birth (63% higher rate)
• increased use of forceps or vacuum
• more interventions overall
Why Electronic Fetal Monitoring Can Change Your Birth Experience
This is the part most parents aren’t told.
When continuous monitoring is used routinely, it can:
Limit Your Movement
The belts keep you close to the bed.
Which makes it harder to:
• walk
• change positions
• use the shower or tub
And movement is one of the most powerful tools for helping labor progress.
(If you want to understand why, read: How to Work With Contractions (Instead of Fighting Them).
Shift Focus Away From You
Instead of watching you—
Providers often watch the monitor.
And that can subtly change how decisions are made.
Lead to a Cascade of Interventions
A “non-reassuring” tracing can lead to:
• position changes
• IV fluids
• oxygen
• amniotomy
• eventually… a C-section
Even when the baby is actually doing fine.
So Why Is It Used So Routinely?
Even with strong research, change in medicine takes time.
Hospitals are balancing:
• safety protocols
• liability concerns
• standard procedures
So continuous monitoring often becomes the default—
even when it’s not always necessary.
What Are Your Options?
For low-risk pregnancies, many providers and midwifery models use: intermittent listening
This means checking baby’s heartbeat at intervals using a handheld Doppler or Fetoscope.
This allows you to:
move freely
stay more comfortable
work with your body
What to Ask About Fetal Monitoring
This is where preparation makes a big difference.
Instead of trying to remember everything—focus on a few key questions:
“Do I need continuous monitoring, or can we use intermittent?”
“Can I still move around while being monitored?”
“Are wireless or waterproof options available?”
These simple questions can completely change how your labor unfolds.
Our Perspective at Our BirthRoom®
We’re not against technology.
We’re for using it intentionally.
Because for many healthy labors:
less intervention = better flow
And when couples understand their options—
they feel more confident
more involved
more in control
The Part Most Parents Aren’t Prepared For
Knowing what something is isn’t the same as knowing how to navigate it in real time.
Because in the moment, you may feel:
overwhelmed
rushed
unsure what to say
Want to Advocate for Yourself With Confidence?
This is exactly why we created something a little different.
Because birth prep isn’t just about labor.
It’s about communication.
It’s about decision-making.
It’s about knowing how to speak up calmly.
Birth Advocate Blueprint™
Inside, you’ll learn:
✨ What to say in real conversations with your provider
✨ How to ask questions without feeling pushy
✨ How to stay calm under pressure
✨ Simple scripts that actually work
So instead of feeling like things are happening to you—
you feel confident navigating them.
Electronic fetal monitoring started with good intentions.
And in the right situations, it still has an important role.
But for many healthy pregnancies—routine use may create more intervention than benefit.
The goal isn’t to reject medical tools.
It’s to use them wisely.
Continue Preparing for Your Birth
If this helped you understand your options more clearly, here’s where to go next:
• Thinking About Induction? Read This First
• How to Work With Contractions (Instead of Fighting Them)
• Train Your Partner to Be a Daddy Doula
