What is fetal distress?

Your doctor or midwife will monitor your baby's heartbeat during pregnancy and labour to assess their wellbeing. Changes to your baby's heart rate may indicate your baby is unwell — known as fetal distress.

Fetal distress usually happens when the baby isn't receiving enough oxygen through the placenta.

What causes fetal distress?

Fetal distress may occur when a 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 living with overweight or obesity
• you have high blood pressure in pregnancyor pre-eclampsia
• you have a chronic disease, such as diabetes or cholestasis (a condition that affects the liver in pregnancy)
• you have a multiple pregnancy
• your baby has fetal growth restriction

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How is fetal distress diagnosed?

Fetal distress is diagnosed by monitoring the baby's heart rate. Your doctor or midwife can do this by:

• intermittent auscultation — this means listening at regular intervals using a device called a hand-held Doppler
• continuous monitoring using a cardiotocograph (CTG)

A slow heart rate, or unusual patterns in the heart rate, may signal fetal distress. In this situation your baby's heart rate is considered abnormal and you will need continuous CTG monitoring.

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

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When should I see my doctor or midwife?

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.

If you haven't felt your baby move, or the pattern of movements has changed, contact your doctor or midwife immediately, as this 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 waters have broken and you notice your amniotic fluid is green or brown. This could signal the presence of meconium (newborn poo, that your baby may pass while still in your uterus if they are distressed).

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How is fetal distress managed?

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

You may be given fluids through a drip into your vein. Sometimes changing position, such as turning onto your side, can reduce the baby's distress.

Your health team may give you medicine to slow down your 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.

Often, there is enough time to discuss your options with your doctor 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 or midwife are aware of this when you arrive at the hospital or birth centre.

Does fetal distress have any lasting effects?

Babies who experience fetal distress are at greater risk of complications after birth. If not diagnosed and addressed quickly, prolonged lack of oxygen during pregnancy and birth can lead to serious complications for the baby. 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.

Resources and support

If your labour didn't go to plan, you may experience difficult feelings about your 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
• PANDA on 1300 726 306
• the Australasian Birth Trauma Association
• Beyond Blue on 1300 22 4636

Learn more about the emotional impact of birth trauma and how to get the right support.