Twenty fetal monitoring myths that won’t go away
Myths about fetal heart rate monitoring are plentiful. Here are twenty of them. Let me know if there are others you would like to see me tackle!
EFM
Electronic fetal monitoring
There’s an invisible human rights issue in maternity care – let’s talk about it
It’s time to highlight the serious issue of unconsented fetal monitoring during childbirth, and the widespread misinformation about its safety and efficacy. It’s time to fix the underlying causes – starting with how guidelines are applied in practice.
How the RANZCOG policy changed
Analysis of the RANZCOG Intrapartum Fetal Surveillance guideline reveals significant changes between the 3rd and 5th editions. Key improvements include clear responsibility shifts to clinicians, realistic evidence levels for CTG use, and better evidence organization regarding risk factors.
I’m 41 weeks pregnant. What’s the deal with CTG monitoring?
RANZCOG’s fifth edition guideline highlights prolonged pregnancy (over 41 weeks) as a risk factor for intrapartum fetal compromise. Low-grade evidence suggests a slight increase in the risk of brain injury for babies born after 41 weeks. The guideline sets out professional’s responsibilities to support women to make their own decisions about fetal monitoring methods.
Thanks 2025 – and now on to 2026!
In 2025, I published 46 blog posts attracted 26,800 readers, and had over a million views on Facebook. I have big plans for 2026 – read on to find out more. Subscribe so you don’t miss out on any of the new things!
There’s a new RANZCOG fetal monitoring policy: What do they get right and what do they get wrong?
The recent fifth edition of RANZCOG’s fetal monitoring guideline adopts a new approach, providing more accurate summaries of the quality of their evidence. Although it emphasises women’s autonomy, they have not quite completed the task of shifting decision-making from obstetricians.
Australian folks – are you interested in joining me in a workshop in the new year for a detailed look at how to apply the guideline to your practice?
Should fetal blood sampling become a thing of the past?
Fetal blood sampling (FBS) has a long history but faces ongoing debates about its relevance. Current evidence shows poor predictive capabilities, and the reliability of fetal blood lactate testing remains disputed. FBS is another example of a fetal monitoring technology that lacks a firm evidence base.
Does CTG monitoring education actually work?
The introduction of the Fetal Surveillance Education Program (FSEP) has been claimed to improve neonatal outcomes. However, the raw data suggests otherwise. A comprehensive literature review indicates inconsistent evidence for CTG training benefits. CTG education should not be mandatory!
Digital fetal monitoring and ethics
I have lived through the rapid evolution of digital technologies. While digital tools offer new possibilities, they also raise ethical concerns, particularly with fetal monitoring. We need to talk about the ethics of digital fetal monitoring more than we currently are.
Why bother?
If you have been hanging around Birth Small Talk for more than a moment, you’ll know I’m very focussed on putting the evidence about fetal heart rate monitoring in front of as many people as possible. And you’ll know that this position puts me at odds with a lot of what most people will hear in mainstream maternity services. So I get some pushback from time to time. And even […]
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