Electronic Fetal Monitoring

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Abstract
DURING the past two decades, there has been a substantial decrease in perinatal mortality. There has also been a concomitant increase in the use of technology in monitoring of pregnancies, as indicated by the use of continuous electronic fetal monitoring (EFM) during labor in as many as 60% to 70% of pregnancies.1,2 This trend in the increasing use of EFM has been associated with opposing societal forces that include (1) an increased emphasis on the "natural" birthing process in which any intervention is viewed with concern; (2) a greater demand for demonstrating efficacy of common practices as well as new technologies; and (3) a greater emphasis on cost-benefit and cost-risk analysis. Challenging the use of EFM most dramatically was a report by Banta and Thacker3that was given unusually wide play in the lay press. This study related the increase in cesarean section rates to the greater use

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