Fetal Distress During Labor

Both excitement and apprehension may be rising as your baby's birth date draws near. Knowing what to expect can help you and your birth coach adjust to sudden changes that can occur in the birthing room, such as "fetal distress." This term means that the baby may have an abnormal heart rate or that his or her oxygen supply is compromised.

A medical dictionary defines fetal distress as "a compromised condition of the fetus, usually discovered during labor, characterized by a markedly abnormal rate or rhythm of myocardial contraction."

What causes fetal distress?

Naturally, expectant mommies wish for a calm and easy pregnancy and delivery-and a healthy newborn. Dealing with the many adjustments your body makes as you progress through the stages of pregnancy can be challenging. And, wondering what complications may arise during labor adds to your list of concerns. Instead of worrying, find out instead what are the possible chances and causes of fetal distress.

Some of the possible causes include:

  • Abnormal position or presentation of the baby

  • Breathing issues (asphyxia)

  • Maternal liver disorder during pregnancy

  • Multiple births

  • Prolapse of the umbilical cord

  • Rupture within the uterus

  • Shoulder dystocia (occurs when the infant's head comes out of the birth canal but its shoulders do not deliver quickly afterward)

Watch for These Indicators

The frequency at which fetal distress occurs is not precisely known, and the numbers range from one in 25 births to one in 100 births.

Earliest signs of fetal distress include:

  • Abnormal heart rate pattern (normal is 120-160 bpm)

  • Significant rise or decrease in the infant's heart rate

  • Umbilical cord flattened or twisted (which affects the heart rate and oxygen levels)

How to Treat This Problem

The most up-to-date recommendations are to have your ob-gyn evaluate all symptoms, and take steps to resolve any fetal distress. In many cases, the "fetal distress" diagnosis has resulted in the ob-gyn recommending delivery of the baby by instrument or by cesarean section.

Be reassured that each woman's body is unique, and the chances of encountering fetal distress during labor vary greatly among pregnant women. For example, women who have given birth vaginally with past pregnancies have a greater chance of doing so in the future. Plus, they have a lower chance of having a rupture within their uterus.

Women who have had any prior cesarean sections have a lower chance of giving birth vaginally with subsequent pregnancies. According to the classic resource on women's health, Our Bodies, Ourselves, you need accurate, unbiased information about your likelihood of various possible outcomes with vaginal birth to make an informed choice. Additionally, you should consider the risks and benefits of your birthing choices in the context of your own life.

Take a Look at the Numbers

The good news is that 85 percent of U.S. pregnancies go full term without complications, according to the U.S. Department of Health and Human Resources. That's a great number that midwives often cite to help expectant moms picture their pregnancy and childbirth as being normal, rather than risky.

In fact, the type of care and coaching a woman receives prior to the due date could possibly make a difference in the outcome. For example, Cara Osborne, CNM, and professor at the Eleanor Mann School of Nursing of Arkansas told Harvard Magazine that she believes that there is an atmosphere of fear created by the medical community that drives many C-sections. Osborne indicated that midwives consider birthing as an evolved, physiologically sound process that, with the right support, usually has good outcomes without complications.

In the end, staying informed about what to do if you encounter fetal distress during your labor process will be a valuable recourse.

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