Nearly every woman who gives birth in an American hospital is strapped with a belt of sensors to track the baby’s heartbeat. If the pattern is deemed abnormal — too slow, for example — doctors often call for an emergency C-section.
But this round-the-clock monitoring, the most common obstetric procedure in the country, rarely helps baby or mother. Decades of research have shown that the tool does not reliably predict fetal distress. In fact, experts say, it leads to many unnecessary surgeries as doctors overreact to its ever-changing readouts.
The obstetrics field has long ignored these problems. Now, it’s putting more trust than ever on the flawed technology, often prioritizing business and legal concerns ahead of what’s best for patients, The New York Times found.
This fall, the American College of Obstetricians and Gynecologists updated its guidelines on continuous monitoring, sanctioning it even as some other wealthy countries have cautioned against its routine use. Some large hospitals have opened remote monitoring hubs, where nurses spend their shifts watching screens of pulsing squiggles beamed in from many miles away. Software companies have also jumped at the opportunity, selling unproven artificial intelligence algorithms that claim to pluck useful signals from the heartbeat noise.
All the while, the rate of cesarean sections in the United States remains stubbornly high. One out of every three deliveries happens in an operating room, a figure that far exceeds public health recommendations. The surgery can prolong a woman’s recovery, complicate future births and sometimes risk her life. The top justification for C-sections in healthy pregnancies is fetal distress, a diagnosis made by the monitor.
“We may be the only specialty that continues to do major abdominal surgery without a shred of evidence of benefit,” said Dr. Steven L. Clark, an obstetrician at Baylor University in Texas who has extensively studied electronic monitoring. “We just plow blithely on.”
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