II. Interventions & C-Sections
Cochrane Review: Continuous Electronic Fetal Monitoring
63% more C-sections, zero additional babies saved
Continuous EFM increases C-section risk by 63% with no improvement in neonatal outcomes vs intermittent listening. For every 11 women on continuous EFM, one additional unnecessary C-section.
Cochrane is the gold standard for systematic reviews in medicine. Their review of continuous electronic fetal monitoring pooled data from multiple randomized trials comparing continuous EFM with intermittent auscultation (a midwife listening with a Doppler at intervals). The finding has held up across updates.
Continuous monitoring raises cesarean rates by 63 percent compared with intermittent listening, and the higher surgery rate does not translate into better neonatal outcomes.
The headline numbers: for every 11 women on continuous EFM, one additional cesarean happens that would not have happened with intermittent listening, and no additional babies are saved. The review did find a small reduction in neonatal seizures, but no difference in cerebral palsy, perinatal death, or low Apgar scores. The technology is still standard in US hospitals.
63%
More C-sections vs intermittent listening
0
Additional babies saved
1 / 11
Extra cesareans per women monitored
Multiple
RCTs pooled, updates consistent
Why it matters
The single most common intervention in US labor is one the strongest level of evidence says causes more surgery without saving more lives. That gap has been documented for decades.
This is one finding from the research library behind How to Birth a Mother. Everything here traces back to a study, a dataset, or a systematic review.