ARPA-H selects pioneering teams to make America the safest place in the world to have a baby 

Selected performer teams will develop breakthrough diagnostics and next-generation fetal monitoring to replace 50-year-old technology and transform labor and delivery 

The Advanced Research Projects Agency for Health (ARPA-H), an agency within the U.S. Department of Health and Human Services, today announced the teams receiving contract awards from its Making Obstetrics Care Smart (MOCS) program. The agency's commitment is up to $34 million in the first year of the four-year, $90.7 million program to revolutionize how mothers and babies are monitored during labor and delivery. If successful, MOCS will save lives, prevent birth complications, and spare the U.S. healthcare system an estimated $1 billion per year in unnecessary procedures alone. 

The MOCS program brings together leading researchers, engineers, clinicians, and technology developers to build two game-changing tools: 1) a rapid point-of-care test that assesses placental health to identify which mothers are at highest risk for complications before labor begins, and 2) a next-generation, noninvasive, wireless fetal monitor powered by artificial intelligence that provides real-time, objective information about a baby's oxygen levels during labor— along with recommended next steps for the care team. 

"Fetal heart rate monitoring is woefully insufficient,” said MOCS Program Manager Kate Arnold, M.D., M.B.A. Today, with the care team and the family doing their best, babies are still born with low oxygen, and unnecessary cesareans are frequently performed. 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, allowing OBGYNs to do only the necessary cesarean sections at the right time. As an OBGYN, that is thrilling and it never would have happened without ARPA-H driving the vision for the future." 

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. Each year, approximately 83,000 unnecessary cesarean sections are performed because clinicians lack reliable data on whether a baby is getting enough oxygen, resulting in $1 billion in avoidable healthcare costs.  

Meanwhile, 134,000 term babies are born annually with severe hypoxia (dangerously low oxygen levels) and nearly a quarter of those infants will suffer neurological complications or death. A root cause of the issue is a 50-year-old fetal electronic monitor that has remained essentially unchanged since the 1970s and fails to reliably tell doctors what they need to know to make informed decisions. MOCS will end this era of guesswork in obstetrics. 

Beyond the direct toll on mothers and babies, the current state of obstetric monitoring drives a cascade of costly consequences: fetal monitoring is a factor in 45% of obstetrics litigation cases, contributing to massive malpractice costs for hospitals. Physician burnout from traumatic deliveries and legal exposure is pushing providers out of obstetrics entirely, worsening an already critical healthcare workforce shortage that hits hardest in rural and underserved communities. 

TA1: Point-of-Care Test for Risk Stratification of Intrapartum Fetal Hypoxia 

These teams will develop rapid, point-of-care diagnostics for use in triage to identify which patients face the highest risk of fetal oxygen deprivation during labor, giving care teams and families critical information at the time of admission. With this technology, families can make informed decisions about delivery sites and care teams can be sure they are staffed for a safe delivery.  

University of California San Diego (UCSD): The team will develop a point of care blood test to evaluate risk of fetal hypoxia, leveraging multiomic analysis of fetal and maternal proteins, nucleic acids, and extracellular vesicles.  

University of North Carolina at Charlotte: The team will develop an autonomous, wearable ultrasound device that uses quantitative measurements from raw signals to evaluate placental health and determine risk of hypoxia during labor without an ultrasound technician or a provider. 

Wyss Institute: The team will develop a microfluidic-based point of care device to capture fetal and placental extracellular vesicles and evaluate the miRNA contents to predict risk of fetal hypoxia.  

MOCS will pilot sharing anonymized biomarker data at the end of Phase 1. Both UCSD and Wyss Institute will collaborate with Massachusetts' Institute of Technology’s PRISM (Precision, Sex-Based Medicine) to ensure that the MOCS efforts will be publicly accessible and have sustained impact that outlasts the program. 

TA2: Novel Intrapartum Fetal Monitor with AI-Driven Decision Support 

These teams will design and build a noninvasive, wireless monitoring devices that integrates fetal heart rate, contraction monitoring, and two additional fetal sensors paired with AI and machine learning to provide real-time, objective data on fetal oxygen levels during labor and recommend the best next steps for intervention.  Because this brings together disparate technology, ARPA-H has made large and small awards and performers will ultimately need to come together into one solution to replace the standard of care.  

Carnegie Mellon University: The team will develop and integrate optical sensing with fetal electroencephalography and NIRS combined with speckle contrast optical spectroscopy into a wearable sensor.  The result will provide insights into maternal cardiovascular function, uterine dynamics, placental reserve, and fetal status never before possible.  

Columbia University: The team will develop a smart belt electrode array with companion ear sensor to separate maternal and fetal signals.  The system is designed to capture signals reliably despite maternal movement and will provide the backbone for integration of additional sensors.  

Tulane University: The team will develop a wearable photoacoustic imaging sensor to non-invasively assess placental and fetal oxygenation during labor.  

University of New South Wales: The team will develop a quantitative ultrasound-derived measurement to monitor uterine perfusion during contractions to quantify fetal reserve. 

Wavelet Medical Inc.: The team will develop a wireless intrapartum fetal electroencephalography monitor to continuously assess fetal cortical activity during labor.  

Collectively, all these teams are delivering on the ARPA-H goal of testing the limits of what is possible. If MOCS is successful, unnecessary C-sections and maternal complications will decrease, infant health will increase, litigation costs will drop, and more physicians will be incentivized to stay in obstetrics — strengthening the healthcare workforce where it is needed most. Meanwhile, mothers, families, and hospital staff will be more comfortable and confident in their choices for critical labor and delivery care. 

For more on MOCS, visit the program page.