What Is a CTG Trace?
If you’ve looked through your maternity records and noticed repeated references to a “CTG trace,” you’re not alone in wondering what it means or what it might tell you about your care.
CTG monitoring is commonly used during pregnancy and labour, particularly when there are concerns about a baby’s wellbeing or when labour is being closely observed. However, the language used in clinical notes can feel technical and difficult to interpret without support.
What does CTG stand for?
CTG stands for cardiotocography. It is a form of monitoring that records two things at the same time:
Your baby’s heart rate
Your uterine activity (contractions)
The information is displayed as a continuous line or “trace” on paper or a digital screen, which healthcare professionals interpret to assess how a baby may be responding before or during labour.
It is widely used in maternity care, but its meaning and implications aren’t always explained clearly at the time.
When is it used?
It may be offered or recommended at different points in pregnancy or labour. This can include:
During labour, particularly in hospital settings
If there are concerns about your baby’s movements
When labour is being induced
If certain risk factors are present
During continuous monitoring in labour
Sometimes CTG monitoring is intermittent, and sometimes it is continuous. The approach used can influence how labour progresses and how care decisions are made, which is why understanding it can feel important afterward.
What does a CTG trace show?
A CTG trace is made up of two main lines.
The top line shows your baby’s heart rate over time. This allows clinicians to look at patterns, including how the heart rate changes with movement or contractions.
The bottom line shows uterine activity essentially how often contractions are happening and how long they last.
Healthcare professionals look at the trace as a whole, rather than focusing on a single moment. Interpretation is based on patterns and trends, not just isolated readings.
How is it interpreted?
These traces are assessed using recognised criteria. They often include:
The baseline heart rate
Variability (how much the heart rate fluctuates)
Accelerations (temporary increases in heart rate)
Decelerations (temporary drops in heart rate)
Based on these features, they are commonly described in maternity notes using terms such as “normal,” “reassuring,” “non-reassuring,” or “abnormal.”
It’s important to know that interpretation involves clinical judgement. The same trace may be viewed differently depending on context, gestation, labour stage, and other factors.
Why CTG traces can feel confusing afterward
Many people only learn about CTG monitoring when they read their maternity records sometimes months or years after the birth. This can raise questions such as:
What prompted CTG monitoring to begin?
What did the trace show at key moments?
Were concerns documented clearly?
How did the CTG influence decisions made during labour?
Because interpretation is technical, brief notes in records may not feel sufficient to explain what was happening at the time.
What CTG information is usually recorded in maternity notes?
Maternity records may include:
Written descriptions of CTG interpretation
Timed entries noting changes or reviews
Decisions made following CTG assessment
Escalation to senior staff
Printed CTG traces stored separately
Sometimes the traces themselves are not included in the main records you receive, or they may be difficult to read without explanation.
When experiences and CTG notes don’t seem to align
It’s not uncommon for people to feel that what they experienced doesn’t match what appears in their notes. For example, you may remember feeling worried or unwell, while the records describe the CTG as “reassuring.”
This doesn’t necessarily mean anyone is wrong. Stress, pain, urgency, and clinical focus can all affect memory and documentation. Understanding the interpretation in context can help bridge that gap.
The role of professional interpretation
CTG traces are not straightforward to interpret without clinical training. Reading guidelines or notes alone can raise concern or confusion without providing reassurance or balance.
A midwife-led maternity records review helps place the findings into context by:
Explaining terminology in plain language
Clarifying how CTG is used in real-world practice
Exploring how the interpretation influenced care decisions
Acknowledging emotional impact alongside clinical detail
This approach focuses on understanding, not judgement.
What understanding your CTG trace can offer
For some people, learning more about their CTG monitoring provides reassurance that care followed expected processes. For others, it helps clarify why certain decisions were made quickly or unexpectedly.
Either way, clarity can reduce uncertainty and support emotional processing particularly after births that felt confusing, frightening, or unresolved.
A gentle reminder
You don’t need to have a specific concern to want to understand your CTG trace. Wanting clarity about your maternity care is valid and reasonable.
Monitoring is just one part of a much wider picture. Understanding it in context alongside your experience can help you make sense of what happened, without pressure or assumptions.
If questions remain after reading your notes, compassionate, midwife-led support can help you explore them at your own pace, with care and professionalism. Get in touch to arrange your 30 minute free consultation with me.
