Background <p>Accurate interpretation of fetal monitoring results is particularly significant in dealing with safety issues during delivery. There are different education programs on fetal monitoring and the education effects are unsatisfactory. This study aims to investigate the effect of constructivist teaching in the improvement of midwives’ interpretation ability regarding fetal monitor graphs.</p> Methods <p>A total of 66 midwives who received the midwifery training from our hospital participated in this study during March 2023 to March 2024. The 66 midwives came from different hospitals in China and possessed different levels of educational attainment and working years. In constructivist teaching, the 66 midwives were divided into 33 groups and each group consisted of 2 persons. Pre-training and post-training assessments were conducted on the 66 midwives. The assessment results before and after the constructivist teaching were collected and analyzed. A questionnaire designed by the researchers was used to investigate the midwives’ understanding and weakness regarding fetal monitoring knowledge and skills.</p> Results <p>Statistically significant differences (<i>P</i> &lt; 0.05) were identified between the scores before and after fetal monitoring training in the 5 aspects: interpretation of uterine contractions, interpretation of baseline fetal heart rate, interpretation of fetal heart rate variability, interpretation of fetal heart rate decelerations, and fetal monitoring comprehensive evaluation. Among the 66 respondents, 83.33% hoped to receive the fetal monitoring training once every 6 months; 75.75% wanted to receive training on typical graph analysis. 92.42% believed that they had benefited the most from typical graph analysis. For the content that needed to be taught emphatically, 87.88% considered typical graph analysis the most important content. For the functional requirements of small programs concerning fetal monitoring training, respondents generally hoped that it should have a variety of functions.</p> Conclusions <p>There are urgent needs for fetal monitoring training among midwives. Constructivist teaching can improve the midwives’ interpretation ability in fetal monitoring graphs and increased their understanding of fetal monitoring.</p>