Your baby’s heartbeat can tell your medical team a lot about how much oxygen your baby is receiving during labour and their general wellbeing. Monitoring your baby’s heartbeat can help us keep you and your baby safe and can help you to make decisions about your care during labour.
There are several options to monitor a baby’s heartbeat. This page provides general information about each of these methods: what they are and when they may be recommended. Not all of these options are available in all birth settings so where you choose to give birth will have an impact on your choices. For more information about where to give birth see: Birthplace decisions Information for pregnant women and partners on planning where to give birth
It is important that you talk about what options you have with your midwife and the medical team looking after you during labour. They will explain the reasons why they are recommending to monitor your baby’s heartbeat and which method they are advising. This advice can change as labour progresses and sometimes, a senior midwife or a doctor may be called to provide a review of your circumstances and give additional advice.
It is important that you get all the information you need and are fully involved in this discussion as each method has its own benefits and risks.
NHS Lothian follows the guidance of the National Institute for Health and Care Excellence which was last updated on 25 March 2026.
Overview | Fetal monitoring in labour | Guidance | NICE
- 1.1 Information and supported decision-making
- 1.2 Assessment during labour and methods for fetal monitoring
- 1.3 Indications for continuous cardiotocography monitoring in labour
- 1.4 Use of cardiotocography for monitoring during labour
- 1.5 Making care decisions based on the cardiotocography trace
- 1.6 Fetal scalp stimulation
- 1.7 Fetal blood sampling
- 1.8 Record keeping for cardiotocography
- Terms used in this guideline
1. Intermittent Auscultation
Your baby’s heartbeat can be monitored at intervals, with a Sonicaid doppler device or Pinard stethoscope. This is called intermittent auscultation.
What is it?
Your baby’s heartbeat is monitored at regular intervals: every 15 minutes during the first stage of labour, and every 5 minutes during the second stage.
When is it recommended?
If your pregnancy is uncomplicated and there are no concerns about you or your baby, research shows that this method is as safe and effective as continuous monitoring.
If this option is not offered to you, it is important that your midwife and medical team explain why they are recommending continuous monitoring instead and that you understand these reasons. For women with a low-risk pregnancy, research shows that there is a chance of increased interventions with continuous CTG monitoring compared with intermittent auscultation. When making a decision, discuss the benefits and risks of each method with your midwife and medical team.
How does it work?
We would use either an electronic Sonicaid device (like your community midwife uses during your antenatal appointments), or a Pinard stethoscope to do this. Midwives are trained to pick up small changes in your baby’s heartbeat that may suggest your baby is becoming stressed. If this happens, we recommend switching to continuous monitoring to give us a clearer picture of your baby’s wellbeing.
Where can it be used?
Intermittent auscultation can be done at home, in the midwife-led unit (Birth Centre) or the maternity team unit (Labour Ward).
Benefits
You can move around freely during labour and use a birth pool.
Things to consider
Some women and birthing people find continuous monitoring more reassuring. We may recommend continuous monitoring if we have any concerns about you or your baby during labour.
2. Continuous Monitoring
Your baby’s heartbeat can be monitored continuously, using a cardiotocograph (CTG).
What is it?
A cardiotocograph (CTG) uses two captors which are secured to your tummy by elastic belts to monitor your baby’s heartbeat, and the frequency and duration of your contractions. It produces a continuous read-out of these two measures which allows us to look for patterns which may suggest how your baby is coping with labour.
Occasionally we cannot get a clear reading from your baby’s heartbeat, usually due to the positioning of Mum or shape of the abdomen. If this happens, we may recommend a fetal scalp electrode (FSE) is attached to your baby to ensure we are monitoring their heart rate properly. An FSE is a small, screw-like device that sits under the skin on the top of your baby’s head to pick up their heartbeat
Where can it be used?
This is only available on the Labour Ward.
When is it recommended?
If there are certain medical concerns for you or your baby which may make labour more complex and potentially higher risk, we would recommend continuous monitoring of your baby’s heartbeat using a CTG. You may also be advised to switch to CTG if concerns develop during labour.
For more information about when continuous CTG monitoring is recommended see: Recommendations | Fetal monitoring in labour | Guidance | NICE
Benefits
We can more closely observe how your baby is coping with the labour process and use the information to safely plan your care with you. This is particularly important if you have any risk factors which may make labour more complex.
Things to consider
CTG devices are usually attached by wire to a machine which can restrict your movement in labour, however we can usually get a bit creative with this so that you can keep upright and mobile which helps with the progress of labour.
For women with a low-risk pregnancy, research shows that there is a chance of increased interventions with continuous CTG monitoring compared with intermittent auscultation.
3. What if I would prefer not to have my baby’s heartbeat listened to?
Your midwife and medical team will explain why checking how your baby is coping during labour is important and will discuss your options with you. They will respect your decision and offer to review your options as labour progresses and if circumstances change.
