What If I Don’t Want Continuous Monitoring During My VBAC?
Understanding CTG monitoring, informed consent, and your birth options during a VBAC
If you’re planning a VBAC, there’s a good chance you’ve already come across the phrase:
“You’ll need continuous monitoring.”
For many women, hearing that can bring up a huge wave of anxiety, not necessarily because of the monitor itself but because of what it seems to represent.
It can mean less freedom and more intervention. You could end up confined to the bed and lose your autonomy because birth becomes something that happens to you rather than with you.
If you’re neurodivergent or carrying previous birth trauma, those feelings can feel even more intense.
First: What IsContinuous Monitoring?
Continuous monitoring usually refers to continuous electronic fetal monitoring (CTG monitoring).
This involves monitors being placed on your abdomen during labour to continuously track your baby’s heartbeat and your contractions.
During a VBAC, continuous monitoring is commonly recommended within the NHS because of the small increased risk of uterine rupture after previous caesarean birth. That risk is around 0.2%-0.5% after one c-section, depending on the study you’re looking at. That risk roughly doubles with 2 previous caesareans but we don’t know for sure what the risk is beyond that. However, many people believe that it doubles again, making the risk around 1.5% with a VBA3C.
The idea is that changes in your baby’s heart rate may help identify concerns earlier.
But while many women are told:
“You have to have continuous monitoring during a VBAC,”
the reality is more nuanced than that.
Recommendations Are Not the Same as Consent
One of the biggest misunderstandings within maternity care is the idea that a recommendation automatically removes choice.
Continuous monitoring may be recommended during a VBAC.
However, informed consent still matters.
That means you are allowed to ask for more information, discuss the alternatives or decline recommendations altogether. This would be a really good scenario to use the BRAIN acronym in.
This does not mean risks disappear but it does mean you remain part of the decision-making process.
Why Some Women Feel Worried About Continuous Monitoring
For some women, continuous monitoring feels reassuring.
For others, it brings up fears around:
restricted movement
increased intervention
sensory overwhelm
loss of privacy
difficulty coping physically during labour
or repeating previous traumatic experiences
Many women planning a VBAC are hoping for a more physiological birth experience after previous caesareans. Movement, comfort and feeling emotionally safe can feel incredibly important.
And for neurodivergent women especially, being attached to monitors or repeatedly repositioned can feel dysregulating and distressing. CTG monitors are notorious for losing the trace which means a midwife has to come in regularly to reposition them. After a while, that becomes so tiring that a woman will just lie still on the bed and try not to move the sensors. This could then lead to the cascade of interventions because the body isn’t allowed to move instinctively and labour stalls.
Continuous Monitoring Does Not Always Mean “Stuck in Bed”
Contrary to what I’ve said above, CTG doesn’t always mean that you have to be lying flat on your back. Many hospitals now offer wireless monitoring which is exactly what it sounds like; the sensors and bands are still on your belly but there’s no restrictive wires. They are also waterproof which means you’re able to use a birth pool if you wanted to, something you can’t do with the wired ones.
This method isn’t perfect though. The connection between the sensors and the monitors are frequently interrupted which still means a midwife has to reposition them regularly.
The important thing is that you deserve clear information about what options are actually available to you.
It’s Also Okay to Ask About the Limitations
This is an important part of informed decision-making too. Continuous monitoring is often presented as something that guarantees safety. But maternity care is rarely that simple.
Monitoring can sometimes pick up false concerns or interrupt your movement. If you’re ND, you could become hyper focused on the data from the CTG and lose your peaceful labour bubble.
It’s also worth noting that a recent study was done which showed that CTG didn’t improve the outcome of birth. This means that CTG didn’t result in less stillbirths but it did result in an increase of interventions, such as assisted deliveries and c-sections.
That does not mean monitoring is inherently bad. It means every intervention has benefits, risks and an emotional impact.
You deserve balanced conversations about all of those things.
Questions You Are Allowed to Ask
If continuous monitoring has been recommended during your VBAC, you are allowed to ask:
Why is this being recommended in my situation?
What specific concerns are we monitoring for?
What are the benefits?
What are the limitations?
Are wireless monitors available?
Will I still be able to move freely?
Can I use water?
What alternatives exist?
What happens if monitoring becomes difficult during labour?
These informed consent questions and something your midwife or consultant should be able to provide informed answers to.
This Is Something We Often Explore During Antenatal Preparation
As a VBAC & neurodivergent doula, this is something I regularly support clients with during antenatal sessions.
Because often the fear is not just:
“What if I need monitoring?”
It’s:
“What if I lose my autonomy again?”
Together we unpack:
previous birth experiences
fears around intervention
sensory needs
movement preferences
hospital policies
communication strategies
and ways to feel more informed and emotionally grounded before labour begins
Sometimes understanding your options clearly can reduce a huge amount of anxiety.
You Deserve More Than Fear-Based Information
Women planning a VBAC are often given information in ways that feel heavily weighted toward risk and worst-case scenarios and while honest discussions around risk absolutely matter, so does emotional safety.
You deserve conversations that are balanced, respectful and rooted in genuine informed consent. Not fear.
(You can read about VBAC safety here.)
If You’d Like Support Navigating This
I’m Shannon, a VBAC & neurodivergent doula based in Cambridgeshire, supporting women across Bedfordshire and Northamptonshire.
I support women planning VBACs who want calm, evidence-based support navigating birth options, antenatal appointments and maternity care conversations, particularly those who feel overwhelmed, anxious or unsupported within the system.
If you’d like support preparing for your VBAC in a way that feels informed, grounded and tailored to your individual needs, you’re very welcome to reach out.