Is continuous monitoring definitely better than very frequent hand held monitoring?

[PSL1990]

I'm deciding between a birth centre and a labour ward for a VBAC. I can't find any evidence to say that continuous monitoring is categorically safe than very regular hand held monitoring. Has anyone looked into this or thought about this? Would love and advice or opinions!

There is actually very little evidence for continuous monitoring in labour. It’s just that we don’t have any other way to try and work out how the baby is coping.

The concern with a previous caesarean is, as I’m sure you know, uterine rupture. The first signs of that can be changes in the trace continuous monitoring will give. Listening in every 15 minutes can’t monitor for more subtle changes and might mean you don’t realise until it’s further on and so instead of a nice calm trip to theatre it’s a big emergency and potentially more risky for you and the baby.

On the other hand continuous monitoring reduces your mobility in labour potentially slowing it down and making it harder for you to cope with so you could end up needing more pain relief than if you were more mobile/able to use the pool.