What is fetal distress?

Fetal distress is a sign that your baby is not well. It happens when the baby isn’t receiving enough oxygen through the placenta.

Fetal distress can sometimes happen during pregnancy, but it’s more common during labour.

What causes fetal distress?

Fetal distress may occur when the baby doesn’t receive enough oxygen because of problems with the placenta (such as placental abruption or placental insufficiency) or problems with the umbilical cord (such as cord prolapse).

It is more common if you are overdue, have pregnancy complications or when there are other complications during labour. Sometimes it happens because the contractions are too strong or too close together.

Your baby is more likely to experience fetal distress if:

• you are obese
• you have high blood pressure in pregnancy or pre-eclampsia
• you have a chronic disease, such as diabetes, kidney disease or cholestasis(a condition that affects the liver in pregnancy)
• you have a multiple pregnancy
• your baby has fetal growth restriction

How is fetal distress diagnosed?

Fetal distress is diagnosed by monitoring the baby’s heart rate. A slow heart rate, or unusual patterns in the heart rate, may signal fetal distress.

Your doctor or midwife might pick up signs of fetal distress as they listen to your baby’s heart during pregnancy.

Your baby’s movements are a sign that your baby is well. A change in your baby’s movements may be a sign of fetal distress.

Another sign of possible fetal distress is meconium in the amniotic fluid. Let your doctor or midwife know right away if your notice your amniotic fluid is green or brown, since this could signal the presence of meconium (newborn poo, that your baby may pass while still in your uterus if they are distressed).

How is fetal distress managed?

There are a few ways that fetal distress may be managed. Your doctor will assess your situation and discuss with you the best management option in your situation.

If you are not in labour

Depending on your situation, your doctor or midwife may recommend interventions such as medicines or intravenous fluids. If these interventions do not help, your doctor may recommend an emergency caesarean section so you birth your baby quickly.

If you are in labour

You will usually be given you oxygen and fluids. Sometimes changing position, such as turning onto your side, can reduce the baby’s distress.

You may be given medicine to slow down the contractions. If you had medicines to speed up labour, these may be stopped if there are signs of fetal distress.

Sometimes, a baby in fetal distress needs to be born quickly. Your doctor may recommend an assisted (or instrumental) birth or you might need to have an emergency caesarean.

Most of the time, there will be time to discuss your options with your doctor and/or midwife. However, in some emergency situations, your doctor or midwife will need to act quickly. If there are any medical interventions you object to, such as receiving a blood donation, it’s a good idea to make sure that your doctor and/or midwife are aware of this when you arrive at the hospital.

Does fetal distress have any lasting effects?

Babies who experience fetal distress are at greater risk of complications after birth. Prolonged lack of oxygen during pregnancy and birth can lead to serious complications for the baby, if it is not noticed and managed early. Complications may include brain injury, cerebral palsy and even stillbirth.

Fetal distress may require an assisted birth or caesarean section. While these interventions are safe, they are associated with their own set of risks and complications. Having fetal distress in one pregnancy doesn’t mean you will necessarily experience fetal distress in your next pregnancy. Every pregnancy is different. If you’re worried about future pregnancies, it can help to talk to your doctor or midwife so they can explain what happened before and during the birth.

Where can I find resources and support?

If your labour didn’t go to plan, you may experience difficult feelings about their birth experience.

If you feel sad, disappointed or traumatised about what happened, it is important to talk to someone. There are lots of people and organisations who can help, including:

• your doctor
• PANDAon 1300 726 306
• Australasian Birth Trauma Association
• Beyond Blueon 1300 22 4636