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Thank you Jenny. There are a lot of issues within this topic. Trying to bring it back to the central issue of whether CTG monitoring is a good thing or not, I’ve yet to hear a good case made for it. Many years ago I worked in a coronary care unit, and we used a centralised bank of ECG monitors, but I think the CTG situation is entirely different. Joy Kemp’s original message noted that it was proposed in her unit to introduce centralised CTG monitoring. It would be interesting to find out who proposed this and why. What is the underlying rationale for this? Some women do need to have CTG monitoring, but as Jenny notes, if she needs this then she needs a midwife with her as well. There is no doubt that routine CTG monitoring can cause significant problems in terms of over-diagnosing fetal compromise. If the centralised system is being used so that one person can sit at a desk and watch a bank of monitors, then that’s a recipe for disaster. Good CTG training emphasises the need to see the whole picture, and not simply rely on a print out or screen reading. Until a centralised system is shown to be a safe and effective way of monitoring several women at once, it certainly should not be used so that midwives can be removed from one-to-one care. The technology allows this to be done, but as far as I am aware a good case has only been made for remote monitoring when we are talking about ‘remote and rural’ areas, where access and distance are problematic. From a clinical risk management point of view I would have thought that saying a woman needs this form of monitoring and then withdrawing the attendant personnel was the equivalent of taking a double-barrelled shotgun and shooting yourself in both feet. The question of storage or archiving is separate: for those women who need CTG monitoring, there is a corresponding need to store this recording for medico-legal purposes. Whether this is paper storage or digital archiving is irrelevant to this argument, since neither method requires a centralised bank of monitors. It seems, from those who have experience of a centralised system, that what happens in practice is that staff do not stay in the room if there is a central monitor. This denies the labouring woman individualised care, and I can’t think of a good reason for this practice. Andrew Symon University of Dundee, Scotland