A fetal monitoring claim examines whether the method and interpretation of monitoring were appropriate, whether concerning findings prompted timely escalation, and whether a different response would probably have prevented injury. Missed monitoring and unaddressed distress are considered within the same care event.
CTG and other records
Cardiotocography, or CTG, produces a continuous trace of the baby's heart rate and contractions. Intermittent auscultation is another method. Key documents include the original CTG trace, clinical notes, partogram and any fetal blood sampling results. Gaps, poor quality traces and missing time markings can themselves be important issues.
Ask for the full trace, not a summary. Electronic systems may store additional data such as alerts and annotations.
Monitoring context
Experts consider whether the type of monitoring suited the clinical situation, including any risk factors in pregnancy or labour. RANZCOG publishes a fetal surveillance guideline, and the guideline current at the time of the birth is relevant for historical claims. Guidelines inform expert opinion but do not automatically decide whether care was negligent.
Escalation decisions
Many claims focus on what happened after a concerning pattern appeared. Was the trace reviewed, was a senior clinician informed, and was a plan made and acted upon? Notes of who reviewed the trace and when are central.
- Times when the trace was classified or reviewed
- Calls to senior obstetric staff
- Decisions about the mode and timing of birth
Causation
Even if escalation was delayed, an expert must assess whether earlier action would probably have avoided or reduced the baby's injury. Brain injury and cerebral palsy can have several causes, some arising before labour. Neonatal imaging, cord blood results and placental pathology help clarify timing.
Expert review
Usually both obstetric and midwifery experts review care, while neonatology, neuroradiology or paediatric neurology experts address causation. Losses for a child with lifelong disability are assessed separately and may interact with NDIS funding.
For your next conversation
- Request the complete electronic CTG trace with timestamps
- Obtain partogram, labour notes and fetal blood sampling results
- Request cord blood gas and placental pathology reports
- Gather neonatal MRI and paediatric neurology reports
- Note any conversation where concerns about the baby's heart rate were raised
Common questions
The hospital says the CTG trace is missing. What does that mean for a claim?
Missing records can complicate a claim but do not necessarily end it. Experts may rely on notes, other data and witness accounts. A solicitor would ask how the record was stored and why it is unavailable, as this may itself be relevant.
Does an abnormal CTG mean my baby's injury was preventable?
No. An abnormal trace indicates concern but does not confirm the cause or timing of injury. Experts must consider whether the injury occurred before monitoring began, and whether a different response would probably have changed the outcome.
Sources & further reading
- RANZCOG: fetal surveillance guideline (opens in a new tab)
- Healthdirect: cerebral palsy (opens in a new tab)
- OAIC: access health information (opens in a new tab)
- Pregnancy, Birth and Baby: labour complications (opens in a new tab)
- NDIS: compensation calculator (opens in a new tab)
These references support the topic’s starting points. They do not determine the facts, standard of care or law applicable to an individual matter.