So why, despite decades of overwhelming evidence, do doctors and patient alike continue to insist on this largely useless and sometimes dangerous procedure? Electronic fetal monitoring was introduced in the 1960s and 1970s without much clinical trial. Still, early studies suggested positive outcomes, and in particular led doctors to believe that the EFM could prevent fetal asphyxia, or interruptions of oxygen to the fetus. Since asphyxia was thought to cause cerebral palsy, doctors were eager to use the new technology, which seemed to promise them greater control over birth than ever before. By the late 1980s however, large-scale trials demonstrated no benefit from EFM. Further research confirmed that consensus, and it has been well-established science for more than 20 years that EFM does not improve obstetric outcomes. But if the science has been against EFM, cultural prejudices have been on its side—and that's proved decisive. Over the course of the twentieth century, and into the twenty-first, birth in the United States has been increasingly medicalized. In part that means there have been more interventions available, including drugs, Cesareans, monitoring, episiotomies, and other surgical options. But it also means that pregnancy has been reconceptualized "as a disruption to health that necessarily requires expert medical intervention, and thinking of pregnancy as primarily about health and illness," according to Amy Mullin, author of Reconceiving Pregnancy and Childcare. Medical technology is seen as necessary, and the more medical technology that's employed, the safer the birth is thought to be. So doctors are reluctant to put aside any tools, even if those tools have been shown not to work. There's another reason for retaining EFM: fear of malpractice. Doctors worry that if they stop using fetal monitors, they'll be held liable for anything that goes wrong. "[M]any professionals believe that their risk of liability is reduced if they have the paper printouts as a record of fetal heart patterns," Carol Sakala, director of programs at Childbirth Connection, told me. But even that excuse doesn't hold up. According to Thomas P. Sartwelle, a partner at Beirne, Maynard & Parsons in Houston, EFM consistently exposes doctors to unnecessary and costly malpractice suits. Doctors frequently disagree about the meaning of EFM print-outs; one study found that four doctors agreed on EFM interpretation in only 22 percent of cases. And yet, Sartwelle told me, EFM print-outs are used in court to claim that the baby did not get enough oxygen during birth, and that a C-section would have prevented cerebral palsy. This, despite the fact that there is no evidence that continuous EFM reduces cerebral palsy (and the link between asphyxia and cerebral palsy is itself largely discredited). "The very thing that [obstetricians are] relying on to protect themselves is the very thing plaintiffs lawyers rely on to prosecute them," Sartwelle said, adding, "Its ubiquity probably gives everyone comfort."
Despite few studies proclaiming its efficacy , Electronic Fetal Monitoring is still a widespread practice in the process of childbirth in the US , according to this New Republic article . The technology is used on 85 % of pregnant women , and is frequently employed to ward off malpractice allegations . A frequent case is that of false positives , doctors losing the signal of a baby 's heartbeat and ordering an emergency c - section or vacuum ##ing , when the technology is actually at fault and the baby perfectly healthy .