BACKGROUND:
Current methods of continuous intrapartum electronic fetal monitoring (CEFM) demonstrate an increase in obstetric intervention without significant neonatal benefit. While it is estimated that 50% of Australian women are monitored in the intrapartum period, little is known about their experiences and capacity to make informed choices.

OBJECTIVES:
To understand Australian women’s experiences of intrapartum fetal monitoring in the last 5 years.

METHODS:
The WOMB Study, a national online survey was distributed between May-July 2022. Analysis included descriptive statistics and association of monitoring type with selected labour and birth outcomes. Qualitative content analysis was used to analyse open text responses.

RESULTS:
We received 866 valid responses. Whilst most women received more than one form of intrapartum monitoring, wired EFM devices were most commonly used. There were significant associations between type of monitoring used and utilisation of pain management techniques, and mode of birth. Handheld monitoring was significantly associated with normal vaginal birth and utilisation of non-pharmacological techniques. Wired EFM was significantly associated with caesarean section and pharmacological pain management. Women preferred handheld or wireless monitoring during labour, citing greater comfort, mobility, and access to non-pharmacological pain relief. Wired monitoring was often described as restrictive and uncomfortable, with over 70% saying they wouldn’t choose it again. Qualitative responses described women’s desire for informed choices and clinicians’ being overly focused on the CTG machine.

CONCLUSIONS:
Intrapartum CEFM is common, regardless of risk factors, with wired monitoring perceived by women to have a negative impact on labour. CEFM was associated with increased use of pharmacological pain management and caesarean section. Understanding women’s experiences of monitoring will enable future implementation of technologies that optimise physiological birth and woman-centred care.

KEY MESSAGE:
Monitoring fetal wellbeing is a fundamental part of labour care. Technologies that facilitate or hinder women’s mobility, autonomy and sense of control, profoundly impact their labour experience. Place of birth - hospital (including three-minute presentation competition)