CTG Monitoring During Labour: What It Is and How It Can Affect Birth
CTG Monitoring in Labour – What I’ve Observed
Let me start by saying clearly: I’m not a medical professional, and this post doesn’t offer advice or guidance about what anyone should or shouldn’t do. Instead, it’s simply an observation piece—one rooted in my experience of supporting many families through birth over the years. This post shares some of what I’ve seen when Continuous Electronic Fetal Monitoring (also known as CTG or cardiotocography) is used in labour.
What is CTG Monitoring?
CTG is a form of continuous monitoring often suggested in hospital births. It’s designed to monitor the baby’s heart rate and track contractions. You may have seen it before—those wiggly lines that appear on a screen or a printout. These lines offer a real-time picture of how baby might be coping with labour.
It’s typically suggested by an obstetrician (a registrar or consultant, for instance), rather than by a midwife, and may be recommended for all sorts of reasons. From what I’ve seen, it can be prompted by things like:
Waters breaking (particularly if they’ve been broken for a while)
Presence of meconium in the waters
A prolonged labour
A non-reassuring heart rate picked up by a Doppler
Light bleeding
Other small factors that raise a flag of caution
The idea behind CTG is that it gives a detailed, continuous trace of the baby’s heart rate in relation to contractions, which can help clinicians gather more information about what’s happening.
Screens in the Room, Eyes on the Trace
Something I’ve noticed again and again—something I’ve even caught myself doing—is how quickly attention in the room shifts to the screen. It’s not just doctors or midwives; it’s everyone. Birth partners, doulas, medical staff—we all start watching the trace.
It’s natural curiosity, really. The screen becomes a kind of centrepiece in the room. Especially with newer systems, the trace can be watched not just by those in the room but by staff outside too. I’ve been told that this can mean the midwife doesn’t necessarily need to be present in the room to keep an eye on how baby appears to be doing.
The flip side of that, though, is that it can mean fewer eyes on the person who is actually giving birth. When attention shifts to the screen, it can be easy to miss the more subtle (but often very telling) signs of how someone is coping—things like changes in position, tone of voice, facial expressions, or when they last had a wee. All of that rich, in-the-moment information can get overshadowed by the data on the screen.
“Just 30 Minutes”
Often, CTG monitoring is introduced with the reassurance of: “We just need 30 minutes to get a good trace.”
You might be told, “You can move around as long as you stay close to the machine,” or perhaps be offered a telemetry version—the wireless Bluetooth-enabled monitors that allow for more mobility. (Although, from what I’ve heard, these are limited in number because they’re considerably more expensive.)
But getting a full 30-minute trace without any gaps is actually quite tricky. Babies move. People in labour move. The little pads (called transducers) that are held in place by stretchy belts can easily lose contact, especially if you're upright, shifting around, or adopting positions that feel more comfortable or instinctive to you.
So that 30-minute request can quickly become 45 minutes, 60 minutes… or longer.
And then, understandably, the suggestion might be: “Shall we just do a bit more, to get a clearer picture?” It’s easy to agree because it sounds reasonable—and of course, everyone wants the best for the baby. But over time, this can build into something that feels more restrictive.
The Impact on Movement
From what I’ve seen, this is where CTG monitoring can have a big knock-on effect—not just physically, but psychologically. People who were planning to be upright, to move, to use the bath, the birth ball, or other active positions, may find themselves slowly but surely spending more and more time on the bed.
Eventually, some reach the point where they feel they have no choice but to lie still, just to “get it over with.” And although that may seem like a small compromise in the moment, it can have a real impact.
Movement in labour isn’t just about comfort. It’s often a vital part of how babies navigate their way through the pelvis. The ability to instinctively change position, to lean, sway, kneel, or rest upright, can support the physiological process and may influence how labour unfolds.
It’s About Balance
Again, I’m not here to say whether CTG monitoring is good or bad. That’s not my place, and I don't offer medical advice.
But what I can say is that, in my experience, continuous monitoring can have a subtle but powerful influence on how labour feels—and how it flows. It changes the atmosphere. It shifts the focus. It can influence movement, mindset, and sometimes even the dynamic between the birthing person and their support team.
None of that means it’s the wrong choice. But it does mean it’s worth understanding. When you’re planning for your birth, especially one where CTG monitoring may be suggested (but even if you feel it’s not likely), it might be helpful to think about how you’d like to be supported to keep moving, stay in tune with your instincts, and remain the central focus in your own birth space.
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Blog: Are Maternity Measurements Serving You? Finding Balance in Birth Choices
