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Background: A variety of technologies are used to monitor fetal wellbeing in labour. Different types of fetal monitoring devices impact women's experiences of labour and birth., Aim: This review aims to understand how continuous electronic fetal monitoring (CEFM) influences women's experiences, with a focus on sense of control, active decision-making and mobility., Methods: A systematic search of the literature was conducted. Findings from qualitative, quantitative and mixed methods studies were analysed to provide a review of current evidence., Findings: Eighteen publications were included. The findings were synthesised into three themes: 'Feeling reassured versus anxious about the welfare of their baby', 'Feeling comfortable and free to be mobile versus feeling uncomfortable and restricted', and 'Feeling respected and empowered to make decisions versus feeling depersonalised with minimal control '. Women experienced discomfort and a lack of mobility as a result of some CEFM technologies. They often felt anxious and had mixed feelings about their baby's welfare whilst these were in use. Some women valued the data produced by CEFM technologies about the welfare of their baby. Many women experienced a sense of depersonalisation and lack of control whilst CEFM technologies were used., Discussion: Fetal monitoring technologies influence women's experiences of labour both positively and negatively. Wireless devices were associated with the most positive response as they enabled greater freedom of movement., Conclusion: The design of emerging fetal monitoring technologies should incorporate elements which foster freedom of movement, are comfortable and provide women with a sense of choice and control. The implementation of fetal monitoring that enables these elements should be prioritised by health professionals., Competing Interests: Conflict of interest There is no conflict of interest to declare., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Qualitative research about women and birthing people's experiences of fetal monitoring during labour and birth is scant. Labour and birth is often impacted by wearable or invasive monitoring devices, however, most published research about fetal monitoring is focused on the wellbeing of the fetus. This manuscript is derived from a larger mixed methods study, 'WOmen's Experiences of Monitoring Baby (The WOMB Study)', aiming to increase understanding of the experiences of women and birthing people in Australia, of being monitored; and about the information they received about fetal monitoring devices during pregnancy. We constructed a national cross-sectional survey that was distributed via social media in May and June, 2022. Responses were received from 861 participants. As far as we are aware, this is the first survey of the experiences of women and birthing people of intrapartum fetal monitoring conducted in Australia. This paper comprises the analysis of the free text survey responses, using qualitative and inductive content analysis. Two categories were constructed, Tending to the machine, which explores participants' perceptions of the way in which clinicians interacted with fetal monitoring technologies; and Impressions of the machine, which explores the direct impact of fetal monitoring devices upon the labour and birth experience of women and birthing people. The findings suggest that some clinicians need to reflect upon the information they provide to women and birthing people about monitoring. For example, freedom of movement is an important aspect of supporting the physiology of labour and managing pain. If freedom of movement is important, the physical restriction created by a wired cardiotocograph is inappropriate. Many participants noticed that clinicians focused their attention primarily on the technology. Prioritising the individual needs of the woman or birthing person is key to providing high quality woman-centred intrapartum care. Women should be provided with adequate information regarding the risks and benefits of different forms of fetal monitoring including how the form of monitoring might impact her labour experience., Competing Interests: I have read the journal’s policy and the first author of this manuscript (DF) has the following competing interests: Deborah Fox has received consultancy fees and research funding for other research projects from Philips Healthcare. Philips Healthcare did not fund this study and had no role in this study., (Copyright: © 2024 Fox et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: Freedom of movement and choice of positioning in labour and birth is known to enhance physiological processes and positive experiences for women during childbirth. Continuous foetal monitoring technologies that enable mobility in labour for women with complex pregnancies, such as wireless CTG, have been marketed for clinical use in most high resource settings since 2003 but there is a paucity of midwifery literature about its clinical use. The aim of this survey was to determine how often, and for whom, wireless and beltless technologies are being used in maternity settings across Australia and New Zealand and to identify any barriers to their uptake., Design: A survey tool developed by Watson et al. (2018) for use in the United Kingdom was adapted for the Australian/New Zealand context. One Maternity Unit Manager or key midwifery clinician from each of 208 public and private hospitals across Australia and New Zealand was invited by email to participate in an online survey between October 2019 and January 2020. Descriptive statistics were used to describe the characteristics of the facilities and the frequency of availability of the monitors. Free text responses were thematically analysed., Findings: The survey received a high (71%) response rate from a range of public and private hospitals in urban and rural settings. Women's freedom of movement and sense of choice and control in labour were seen by most respondents to be positively influenced by wireless monitoring technology. Most facilities reported having at least one wireless or beltless foetal monitor available, however, results suggest that many women consenting to continuous monitoring still do not have access to technology that enables freedom of movement., Keyconclusions: Further research is required to explore the barriers and facilitators to enabling freedom of movement and positioning to all women in childbirth, including those women with complex pregnancies who may consent to continuous foetal monitoring., Competing Interests: Declaration of Competing Interest The first author, Dr Deborah Fox, has received honoraria for presenting workshops to clinical midwives on freedom of movement and positioning in labour and birth, from Philips Australia and New Zealand., (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)