Birth injuries series - Fetal distress

17 June 2015

Unborn babies whatever their size or gestation can become physically distressed during the often long process of labour. When labour does not progress as expected or takes an unusually long time, a baby’s reserves of strength and energy can run out. Experienced midwives and doctors will keep the health and well-being of the unborn baby central to their thoughts. They will keep the condition of the baby monitored regularly throughout the labour (by various methods) to ensure the baby is standing up well to the pressures and force of contractions.

With the use of regular levels of monitoring it should be possible for staff to identify signs and indicators that the unborn baby is becoming distressed. When the signs of distress are picked up quickly the correct and most appropriate course of action can be identified. This may result in a decision to perform a caesarean section, or an instrumental delivery (forceps or ventouse) to ensure the safe delivery of the baby before any damaging injuries arise.

Fetal distress can be identified in a number of ways. One indicator is that the baby’s heart rate has become irregular when listened to by Pinard stethoscope (the traditional method used by midwives to listen to the fetal heart), or recorded on a CTG monitoring machine. The heart rate can slow down and be slow to recover after contractions (bradycardia) which may indicate that the baby is not receiving sufficient oxygen. This slowing of the baby’s heart rate may be described as “decelerations” or “dips” in the fetal heart rate. The baby may also open it’s bowels in the womb. This is known as passing meconium and again may be a sign of distress.

If fetal heart decelerations and other signs of distress are not identified appropriately and acted upon swiftly, this can result in serious injuries to the baby and in extreme situations death.

If a baby is suspected of being distressed prior to delivery by caesarean or vaginal delivery then it may well require immediate help from a neonatal or paediatric team. The speed of response from appropriate doctors after the birth can also make a dramatic difference to the recovery of a baby.

A baby who has suffered from distress or other problems prior to delivery should be identified quickly by staff. The baby may be delivered in a poor, weak and floppy condition and identified as having a low APGAR score. This is a simple scoring system used to assess the condition of all newborn babies, usually at one, five and sometimes ten minutes after birth. Samples of blood may also be taken from the umbilical cord and these samples will also give the doctors an indication of the baby’s condition.

In cases involving very serious fetal distress a baby will usually require active ventilation and resuscitation and may suffer from fits shortly after birth. These babies require a high level of specialist neonatal care and management to ensure any further damage is minimised and to achieve optimum recovery.

Sometimes, babies who have suffered from fetal distress and were in a poor condition at birth will go on to be diagnosed with cerebral palsy. Where it can be shown that the appropriate steps were not taken by the staff concerned and that earlier intervention or delivery would have made a difference to the outcome then a successful claim for compensation may be achieved, with the help of good legal advice, and suitable experts.

This article first appeared in At Home Magazine. 

Further information

For more information, please visit our page on Cerebral Palsy and Birth Injury. You may also be interested in reading some of our other blogs on this topic, including; 

Kingsley Napley is experienced in acting in clinical negligence claims relating birth injuries. If you would like advice, please contact the Clinical Negligence and Personal Injury team on 020 7814 1200 or by emailing us at

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