<b><i>Background:</i></b> International newborn resuscitation guidelines recommend electrocardiogram (ECG) heart rate (HR) monitoring at birth. We evaluated the application time of pre-set ECG electrodes fixed to a polyethene patch allowing adhesive-free attachment to the wet skin of the newborn chest. <b><i>Objectives:</i></b> Using a three-electrode pre-set ECG patch configuration, application success was calculated using video analysis and measured at three time points, the time to (1) apply electrodes; (2) detect recognizable QRS complexes after application; and (3) display a HR after application. <b><i>Method:</i></b> A prospective observational study in two UK tertiary maternity units was undertaken with 71 newborns including 23 who required resuscitation. <b><i>Results:</i></b> The median (IQR) time for ECG patch application was 8 (6–10) seconds, detection of recognizable QRS complexes 8 (2–12) seconds, and time to output HR was 23 (15–37) seconds. <b><i>Conclusion:</i></b> Pre-set ECG chest electrodes allow rapid HR information at birth without electrode detachment or compromising skin integrity.