The Advanced Research Projects Agency for Health (ARPA-H) has announced contract awards for its Making Obstetrics Care Smart (MOCS) program, committing up to $34 million in year one of a four-year, $90.7 million initiative to develop breakthrough diagnostics and next-generation fetal monitoring for labor and delivery.
The program aims to build two tools: A rapid point-of-care test that assesses placental health to identify which mothers are at highest risk for complications before labor begins, and a noninvasive, wireless fetal monitor powered by AI that provides real-time, objective information about fetal oxygen levels during labor with recommended next steps for care teams.
The need is urgent. The U.S. has the highest rate of maternal and infant morbidity and mortality of any wealthy nation, despite spending more per capita on maternal care than any other country. Approximately 83,000 unnecessary cesarean sections are performed each year because clinicians lack reliable data on whether a baby is getting enough oxygen – resulting in $1 billion in avoidable costs. Meanwhile, 134,000 term babies are born annually with severe hypoxia, and nearly a quarter suffer neurological complications or death. The root cause: Electronic fetal monitoring technology that has remained essentially unchanged since the 1970s.
“Fetal heart rate monitoring is woefully insufficient,” said MOCS program manager Dr. Kate Arnold. “MOCS performers will develop cutting-edge sensing technology, paired with AI, to give care teams and families the real-time, actionable information they deserve. This work will forever change how we practice obstetrics.”
Eight teams have been selected across two technical areas. For point-of-care risk stratification: UC San Diego (multiomic blood test), UNC Charlotte (autonomous wearable ultrasound for placental health assessment), and Wyss Institute (microfluidic device capturing fetal extracellular vesicles). For next-generation monitoring: Carnegie Mellon (optical sensing with fetal EEG), Columbia University (smart belt electrode array), Tulane (wearable photoacoustic imaging), University of New South Wales (quantitative ultrasound for uterine perfusion), and Wavelet Medical (wireless fetal EEG).
Both UC San Diego and Wyss Institute will collaborate with MIT’s PRISM (Precision, Sex-Based Medicine) program to ensure publicly accessible biomarker data with sustained impact beyond the program.
Beyond the direct toll on mothers and babies, current monitoring failures drive 45% of obstetrics litigation, contributing to physician burnout and workforce attrition that hits hardest in rural and underserved communities. If successful, MOCS could reduce unnecessary C-sections, decrease maternal complications, lower litigation costs, and help retain providers in obstetrics.
