In many cases, pregnancy and birth are long and uncomfortable, but ultimately uneventful processes (that is, up until your baby's big debut). But sometimes, pregnancy or labor complications can cause an unborn baby to go into fetal distress, which can be dangerous and may require immediate delivery.
Here's what you need to know about this relatively rare complication, including tips to reduce your risk.
What is fetal distress?
Fetal distress (what doctors prefer to call "nonreassuring fetal status") is when your practitioner is concerned that your baby's oxygen supply may be compromised in utero before or during labor. Oxygen deprivation can result in decreased fetal heart rate and requires immediate action to protect your baby.
What causes fetal distress?
Fetal distress is associated with a number of factors, including:
- Fetal growth restriction (FGR)
- Preeclampsia
- Placental abruption
- Uncontrolled diabetes
- Too much amniotic fluid
- Low levels of amniotic fluid
- A pregnancy lasting longer than 40 weeks
- Labor complications, including labor going too quickly or lasting too long
- Umbilical cord prolapse, compression or entanglement
- Staying in a position (usually flat on your back during labor) for a long period of time, which eventually puts pressure on your major blood vessels and cuts off oxygen to your baby[1]
What are the signs of fetal distress?
You may be experiencing signs of fetal distress if you or your doctor notes that:
- Your baby has a decreased heart rate
- Your baby has a different (on nonexistent) pattern of fetal movement after week 28
- Your water breaks and is greenish-brown (that's baby's first poop; some babies who pass this meconium while still in the uterus may be in distress)
The only way to examine whether your baby's in fetal distress is with a continuous fetal monitor, nonstress test, or an ultrasound and biophysical profile. However, these tests have limitations and may provide false positive results because they indirectly assess how much oxygen your baby is getting.
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Who is most at risk for fetal distress?
Several conditions may put your baby at increased risk for fetal distress, including:
- Fetal growth restriction
- Too much or too little amniotic fluid
- Preeclampsia
- Uncontrolled diabetes
- Placental abruption
- Umbilical cord problems
- A long or complicated labor
- An overdue pregnancy
What can you do if your baby is in distress?
If you've noticed a change in fetal activity or your kick count is off and you're concerned, call your practitioner right away. Also reach out immediately if your water has broken and is greenish-brown, which means it's stained with meconium.
When you arrive at your practitioner's office or the hospital, you'll get placed on a fetal monitor to check on your baby's fetal heart rate pattern.[2] You may also receive supplemental oxygen to help oxygenate your blood, as well as IV fluids, which may help improve your baby's heart rate pattern on the monitor. (Your doctor will take these same steps if he or she notices your baby's in distress during a routine checkup or nonstress test.)
If you're already in labor, you may need to switch positions. You may also be taken off of contraction-inducing drugs (oxytocin) or given a medication to slow contractions.
If these techniques don't work, the best treatment is a quick delivery, often by C-section.
Is there anything you can do to prevent fetal distress?
While you can't prevent fetal distress, you can lower the odds it'll happen to you by going to all of your prenatal appointments and following your doctor's recommendations for a healthy pregnancy. These tips are especially important if you've been diagnosed with a condition that increases your risk of fetal distress, like preeclampsia or gestational diabetes.
Many people don't necessarily notice a baby is in fetal distress, so an increasing number of prenatal appointments during the last few weeks of pregnancy allows your doctor to monitor your baby's heart rate, measure your belly and ask you about your baby's movements to ensure everything's going as expected. A baby with a strong, stable heartbeat with appropriate movements is doing well.
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