During labor and delivery, a baby can not tell the doctor, obstetrician, nurse midwife, or nurse if he or she is in distress. Or can they? A baby may not be able to talk, but the fetal monitor strips are speaking on behalf of the baby. The fetal monitor strips will show if the baby is in distress during labor or delivery. The doctors and nurses caring for the woman in labor need to pay close attention to the fetal monitor strips and what the baby is trying to tell them. If the baby is showing signs of distress, measures must be taken to prevent a birth injury.
When a woman is in labor, there are a few ways the obstetrical team can monitor the health of the baby. Most frequently, an external fetal monitor is placed on the mother’s abdomen or belly. This monitor not only detects the baby’s heartbeat, it also measures the pressure of the contracting uterus. Another way to monitor the baby is with an internal lead or internal monitor also known as a fetal scalp electrode. This type of monitoring may be used if an external fetal monitor is not properly detecting the baby’s heart beat due to the baby being small or premature, or the mother’s body habitus.
Whether it is an external or internal monitor, they both will transmit the baby’s heart rate onto graph paper called a fetal monitor strip. The fetal monitor strip will graph the baby’s heart rate and how the baby is tolerating the labor and contractions. During contractions, it is normal to see some fluctuations in the baby’s heart rate. A normal fetal heart rate is in between 120 – 160 beats per minute. A variation from the baseline heart rate is called beat to beat variability or short term variability and it shows a healthy, intact brain and nervous system. A loss of that variability could mean the baby is in distress or just sleeping. An increase in the variability could mean fetal hypoxia, or a lack of oxygen, or compression of the umbilical cord. At times, the monitor will show early, late, or variable decelerations. Decelerations or a decrease in the heart rate could be warning to the doctor or nurse that the baby is in distress and not receiving the oxygen it needs. Prolonged decelerations can lead to bradycardia or a very low heart rate that can also cause profound injury to the baby’s delicate brain. The opposite of bradycardia is tachycardia or a high heart rate. Tachycardia on a fetal monitor strip can indicate that the baby is suffering from an overwhelming infection or is trying to survive or get more oxygen.
If obstetricians, nurse midwives, nurse practitioners, or nurses do not constantly monitor and address what the baby is “telling" them on the fetal monitor strips, it could lead to hypoxia or a lack of oxygen to the baby’s brain, brain damage, cerebral palsy, a still birth, or death. If you think your baby was injured during birth, you need to contact an attorney or law firm that is experienced in reading and interpreting fetal monitor strips. At the nationally known Beasley medical malpractice firm, we not only have highly experienced lawyers that have successfully litigated and won birth injury cases, we also have highly specialized teams of nurses and doctors on staff. Our specialized birth injury team is made up of doctors, and nurses that have collectively worked over 55 years in the hospital, in labor and delivery units and have monitored and interpreted thousands of fetal monitor strips. We really do understand what the baby was trying to tell the doctor.
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