Carnegie Mellon-Led Team Secures Up to $39.3 Million ARPA-H Award to Develop OMEGA Fetal Monitoring System
Carnegie Mellon University is spearheading a major multi-institution research initiative aimed at transforming how clinicians detect fetal distress during labor and delivery, after securing an award of up to $39.3 million from the Advanced Research Projects Agency for Health (ARPA-H). The project will support the development of OMEGA, a next-generation wearable fetal monitoring system designed to provide a more direct, accurate, and comprehensive assessment of fetal oxygenation and distress than the fetal heart rate monitoring tools that have remained the standard of care for decades.
The system, formally known as Optical, Mechanical, and Electrical Global Assessment of fetal hypoxia, is intended to address one of the most persistent challenges in obstetric medicine: determining whether a baby in labor is truly in distress, whether oxygen delivery is compromised, and what is causing the problem. By replacing indirect and often unreliable fetal heart rate monitoring methods with a unified platform that can assess oxygen delivery and fetal adaptive capacity in real time, the OMEGA program aims to equip care teams with a much clearer picture of maternal-fetal health during childbirth.
The effort is being funded under ARPA-H’s Making Obstetric Care Smart program, which seeks to foster bold technologies capable of improving maternal and infant outcomes. OMEGA is being led by Jana Kainerstorfer, professor of biomedical engineering at Carnegie Mellon University, and co-led by Tiffany Ko, Ph.D., a research scientist with the Children’s Hospital of Philadelphia’s Resuscitation Science Center. Together, they are coordinating a nine-institution collaboration spanning the United States and Europe, with expertise ranging from biomedical optics and obstetrics to neonatal care, sensor engineering, and translational clinical research.
Addressing a Longstanding Gap in Labor and Delivery Monitoring
Although childbirth care has evolved dramatically in many areas over the last half century, the basic approach to fetal monitoring during labor has remained largely unchanged since the 1970s. In most hospitals, clinicians still rely heavily on contraction monitoring and fetal heart rate tracings to infer whether a fetus may be experiencing distress. These methods can reveal changes in heart rate patterns that suggest a problem, but they do not directly tell clinicians whether the fetus is becoming deprived of oxygen, how severe that oxygen deficit may be, or what physiological mechanism is driving it.
That limitation has major implications in delivery rooms. If fetal distress is suspected, obstetric teams often have to make urgent decisions with incomplete information. In many cases, the concern that a baby might be compromised can lead to an emergency Cesarean delivery, even when the underlying cause of the abnormal heart rate pattern is uncertain. In the United States, C-sections account for roughly one-third of all births, and many are performed because of concern about possible fetal distress. Yet without a direct way to measure fetal oxygenation, clinicians are frequently left to interpret ambiguous signals rather than objective evidence of hypoxia.
Kainerstorfer said that gap in information is exactly what the OMEGA project is designed to address. When a fetus is suspected of being hypoxic, she noted, care teams may have to act quickly without understanding the reason behind the problem. The ability to directly measure whether a fetus is not getting enough oxygen—and to determine why—could fundamentally change obstetric decision-making by helping clinicians distinguish between cases that require urgent intervention and those that may be managed more safely with continued monitoring.
Moving Beyond Heart Rate to a Systems-Level View of Fetal Distress
A central feature of OMEGA is that it is not designed to look at the fetus in isolation. Instead, the platform is being built as a systems-level monitoring solution that examines the interconnected physiology of the mother, placenta, uterus, and fetus in real time. That broader perspective reflects the reality that fetal hypoxia during labor can arise from multiple causes, including maternal cardiovascular factors, placental insufficiency, umbilical cord compression, uterine contractions that temporarily limit oxygen delivery, or the fetus’s own reduced ability to compensate.
To capture that complexity, OMEGA will combine multiple noninvasive sensors into a wearable monitoring system capable of collecting optical, mechanical, and electrical signals from across the maternal-fetal unit. The goal is not simply to flag distress, but to help clinicians understand the underlying mechanism of that distress. By integrating data from several physiological domains, the system is intended to offer a more interpretable and clinically actionable picture of what is happening during labor.
This mechanistic approach is one of the project’s defining features. Traditional fetal monitoring often answers only one limited question: whether the fetal heart rate pattern looks reassuring or concerning. OMEGA aims to answer a more clinically useful set of questions: Is the fetus receiving enough oxygen? Is oxygen delivery falling? Is the fetus compensating appropriately? Is the problem being driven by the mother, the placenta, uterine activity, or fetal physiology itself?
If successful, that shift could represent one of the most meaningful advances in intrapartum monitoring in decades.
Rooted in Carnegie Mellon’s Biomedical Optics Expertise
Although OMEGA is a new program, it builds directly on Kainerstorfer’s broader research in biomedical optics and noninvasive physiological monitoring. Her work has focused on how to measure oxygenation and blood flow deep inside tissue without directly accessing the tissue itself—a challenge that appears across multiple areas of medicine, from monitoring brain physiology to evaluating fetal health.
Kainerstorfer has previously worked on optical technologies aimed at assessing oxygen delivery and hemodynamics in the brain and in fetal settings, making the OMEGA project a natural extension of that scientific foundation. At its core, she said, her research is driven by a recurring question: how does oxygen, and the lack of oxygen, affect the brain and other vital tissues across all stages of life? From a technology perspective, that translates into the challenge of measuring physiological processes in places clinicians cannot directly see.
Fetal monitoring is a particularly difficult version of that problem. The fetus is enclosed within the maternal body, and its oxygen status depends on a complex chain of maternal circulation, placental function, and fetal adaptation. Existing tools provide only partial clues about that system. OMEGA is an attempt to bring together advances in sensing, data interpretation, and physiological modeling to make that hidden biology more visible during labor.
Broad Collaboration Across Hospitals, Universities, and International Research Centers
The scale of the OMEGA award reflects the complexity of the challenge and the breadth of expertise required to solve it. Carnegie Mellon and CHOP are leading a team that includes UPMC Magee-Womens Hospital, the University of Pittsburgh, the University of Notre Dame, Washington University in St. Louis, the University of Pennsylvania, the Institute of Photonic Sciences in Barcelona, Spain, and Tyndall National Institute in Cork, Ireland.
This network brings together specialists in engineering, obstetrics, neonatology, maternal-fetal medicine, biomedical imaging, photonics, and translational health research. The aim is to create not just a laboratory prototype, but a clinically relevant monitoring system that can function in the realities of labor and delivery environments.
Tiffany Ko of CHOP said the project represents an opportunity to close the gap between what clinicians need—reliable, real-time clarity—and what current monitoring methods can provide. She emphasized that the team is focused on methods that are rigorous, interpretable, and practical for real-world use in delivery rooms. For Ko and the CHOP team, the project’s importance lies in its potential to directly improve outcomes for mothers and babies by giving care teams better tools to understand fetal condition as labor unfolds.
Potential to Improve Outcomes and Reduce Unnecessary C-Sections
The clinical and public health implications of a successful OMEGA system could be substantial. The United States continues to report higher maternal and infant morbidity and mortality rates than other wealthy nations, despite spending more per capita on maternal healthcare. At the same time, C-section rates remain high, with many procedures driven at least in part by uncertainty about fetal well-being during labor.
The World Health Organization has reported that C-section rates above 15% do not reduce mortality at a population level, suggesting that a significant portion of surgical deliveries may not provide clear health benefits. In the U.S., however, the rate is roughly double that threshold. Some of those procedures are unquestionably lifesaving and medically necessary, but others may occur because clinicians lack reliable tools to distinguish true fetal compromise from transient or non-threatening abnormalities in fetal heart rate patterns.
OMEGA could help change that dynamic. By providing more direct information about fetal oxygenation and the physiological cause of distress, the technology may enable more confident and targeted clinical decisions. In some cases, that could mean acting faster when a fetus is genuinely in danger. In others, it could mean avoiding unnecessary emergency interventions when oxygenation is adequate and the fetus is compensating appropriately.
If the system proves effective in clinical use, it could potentially help reduce unnecessary C-sections, improve maternal recovery, lower the risk of surgical complications, and reduce healthcare costs. It may also lessen the burden of hospital litigation related to labor and delivery, an area where questions about fetal monitoring and timing of intervention often play a major role.
Building a Smarter Labor and Delivery Room
For clinicians working in obstetrics, the need for better data during labor is immediate and practical. Hyagriv Simhan, M.D., OB/GYN and Executive Vice Chair of Obstetrical Services at UPMC Magee-Womens Hospital and professor of obstetrics and gynecology at the University of Pittsburgh, described pregnancy as both a natural physiological process and a significant medical stressor for the mother and fetus. He noted that clinicians are frequently required to make difficult decisions during childbirth using incomplete and unreliable information.
Simhan said the collaboration on OMEGA represents a promising step toward a future in which new technology and artificial intelligence-driven insights could help revolutionize the labor and delivery room. Rather than depending solely on patterns that are indirect and sometimes difficult to interpret, clinicians could have access to a more sophisticated understanding of fetal physiology and risk in real time.
That vision aligns closely with ARPA-H’s mission to accelerate high-impact health technologies that can reshape care delivery. In the case of OMEGA, the ambition is not merely to improve an existing monitor, but to rethink what fetal monitoring should look like in the modern era: data-rich, mechanistic, interpretable, and centered on meaningful clinical outcomes rather than surrogate signals alone.
A High-Stakes Opportunity for Maternal and Fetal Care
The OMEGA project arrives at a time of increasing concern about maternal health, birth outcomes, and persistent inequities in obstetric care. Better fetal monitoring alone will not solve those systemic challenges, but it could address one of the most consequential decision points in childbirth: determining when a fetus is truly in danger and what intervention is most appropriate.
For Carnegie Mellon and its collaborators, the project represents both a technical challenge and a clinical opportunity. Developing a wearable system that can accurately assess fetal oxygenation in the dynamic environment of labor is an ambitious goal, but one with potentially far-reaching implications. If OMEGA can deliver the kind of real-time physiological insight the team is aiming for, it could help shift labor and delivery care away from decades-old monitoring assumptions and toward a more precise, evidence-based model of decision-making.
In that sense, the ARPA-H award is not just a funding milestone—it is an endorsement of the idea that obstetric care is overdue for a technological leap. With up to $39.3 million in support and a broad network of engineering and clinical partners, Carnegie Mellon’s OMEGA initiative now has the opportunity to test whether a smarter, more informative approach to fetal monitoring can make childbirth safer for both mothers and babies.
About the College of Engineering: The College of Engineering at Carnegie Mellon University is a top-ranked engineering college that is known for our intentional focus on cross-disciplinary collaboration in research. The College is well-known for working on problems of both scientific and practical importance. Our “maker” culture is ingrained in all that we do, leading to novel approaches and transformative results. Our acclaimed faculty have a focus on innovation management and engineering to yield transformative results that will drive the intellectual and economic vitality of our community, nation, and world. The project is supported by the Engineering Research Accelerator.
