CTG vs. Intermittent Monitoring: What’s the Difference?

When you’re preparing for birth, you might hear about different ways to check your baby’s heartbeat during labour. Two of the most common methods are CTG (Continuous Fetal Monitoring) and Intermittent Monitoring. Understanding how these work and the differences between them can help you feel more confident about what to expect.

What Is Continuous Fetal Monitoring (CTG)?

CTG, or continuous monitoring, uses sensors on your belly to keep track of your baby’s heartbeat and your contractions. This can be done:

  • Externally with bands around your abdomen.

  • Internally using a small coil placed on your baby’s scalp, if more detailed monitoring is needed.

CTG is often used in high-risk pregnancies, such as when labour is being induced, an epidural is used, or there are concerns about your baby’s wellbeing. It gives your care team a constant update on how your baby is coping during labour.

What Is Intermittent Monitoring?

Intermittent monitoring is done at regular intervals using a handheld Doppler or a Pinard stethoscope. A midwife listens to your baby’s heartbeat:

  • Every 15 minutes during active labour.

  • Every 5 minutes during the pushing stage.

This method is typically used in low-risk pregnancies and allows you to stay more mobile during labour.

How Are They Different?

CTG keeps track of your baby’s heartbeat all the time, but it usually means you’ll need to stay in one place or near the machine. This can make it harder to move around during labour.

Intermittent monitoring checks the baby’s heartbeat at set times, which means you can stay more active and move freely. This can help labour progress and make you feel more comfortable.

What Do the Studies Say?

The decision between CTG and intermittent monitoring often depends on whether your pregnancy is high-risk or low-risk. But what does the research show about their outcomes?

  1. CTG Monitoring

  • Studies have found that CTG does not reduce the number of babies who die around birth compared to intermittent monitoring.

  • However, it is linked to a slight reduction in neonatal seizures (fits in newborns).

  • CTG is also associated with higher rates of interventions, such as caesarean births or the use of forceps, because it can pick up small changes that might not always be a problem.

  1. Intermittent Monitoring

  • For low-risk pregnancies, intermittent monitoring is just as safe as CTG.

  • It reduces the likelihood of unnecessary interventions, helping to keep labour as natural as possible.

Which Is Best for You?

The type of monitoring that’s right for you will depend on your pregnancy and how your labour is progressing.

  • CTG may be recommended if you’re having a high-risk pregnancy, such as being induced, having an epidural, or if there are concerns about your baby.

  • Intermittent monitoring is often used for low-risk pregnancies and can help you stay active during labour, which is shown to support labour progress and comfort.

Both methods aim to ensure the safety of you and your baby, but they work in different ways.

Things to Consider

  • If you want more movement: Intermittent monitoring allows you to walk, change positions, and use the pool if you’re having a water birth.

  • If you feel reassured by constant updates: CTG provides a continuous picture of your baby’s wellbeing, which can feel comforting in some situations.

It’s important to talk with your midwife or doctor about your preferences and what might work best for you, especially if your pregnancy is considered higher risk.

Final Thoughts

Monitoring your baby’s heartbeat during labour is an important part of ensuring a safe birth. Both CTG and intermittent monitoring have their benefits, depending on your situation.

The key is to feel informed and prepared, so you can discuss your options with your care team and make the best decision for you and your baby. Birth is unpredictable, but having knowledge about these methods can help you feel more confident and in control.

If you have questions, speak with your midwife—they’re there to help you every step of the way.

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