Many women have been told during labor that intervention is required because of Fetal Distress. Some of the reasons are genuine, and potentially leading to complications for the baby, including death. On the other hand, labeling of many situations and conditions as Fetal Distress is not only inaccurate but also premature. In this post I will try to demystify what is Fetal Distress and how it is caused.
According to the National Institute of Health’s Medline Plus site, the Placenta is that organ which nourishes the developing baby in the womb. The umbilical cord originates from one side of the placenta, which is attached to the mother’s uterus and ends on the fetal surface. The placenta is responsible for facilitating exchange of oxygen and carbon dioxide between mother and the growing baby. How these gases move back and forth between the placenta and the baby’s blood vessels is due to a difference in pressure between the “umbilical blood vessels” and “maternal blood vessels”. How these pressures are developed and maintained is a function of various physiological and biochemical conditions during pregnancy and labor.
During labor, the uterus experiences higher pressure because of contractions, which causes placental blood flow to be reduced. When contractions stop normal blood flow resumes. Studies have shown that if labor is allowed to proceed on its own without drugs or other external interventions, the baby can deal well with this reduction of blood flow during contractions. In normal labor, a gradual decrease in supply of oxygen to the fetus occurs with each contraction, and reaches its lowest point some 90 secs after the peak of each contraction and takes a further 90 secs to to recover. Even then, care providers should periodically check the FHR to ensure it does not drop off steeply. The effect of many drugs such as Pitocin, is to cause stronger and long lasting contractions which occur more closer to each other, leading to additional complications. Prolonged cord compression has also been shown to result in decreased oxygen to the baby causing fetal distress in labor. Baby becomes stressed if mother is stressed or if she is not adequately well nourished before labor. This causes baby’s cardiac output to reduce because of less availability of oxygen. This causes a rise in fetal blood pressure in order to compensate for decreased blood flow, resulting in fall in fetal heart rate.
We recommend parents talk to their health care providers to avoid induction, continuous electronic monitoring, augmentation, artificial rupture of membrane or to have mothers immobile during labor. Mothers should move about according to their convenience, take plenty of fluids and nourishment, and should avoid being stressed.