Fetal Distress

When the fetus is not coping well during labor, it indicates fetal distress. Fetal distress is rare and may not occur if the mother and the fetus have been progressing well through pregnancy. The term fetal distress is normally used when the baby's oxygen supply is compromised in the uterus.

During fetal distress, the heart rate of the fetus is monitored continuously using an electronic heartbeat monitor. Symptoms of fetal distress include:

• Mother feels decreased fetal movement
  
• Meconium in the amniotic fluid
  
• Increased/decreased heart beat in fetus particularly after contractions

Causes for fetal distress

• Oxygen supply through the umbilical cord has reduced
  
• Delivery is happening beyond the expected date of delivery
  
• Abnormal presentation or position of fetus
  
• Prolonged labor
  
• Contractions are happening very fast for the mother
  
• Baby size is smaller than average
  
• Prolapse of the umbilical cord
  
• Placental abruption, wherein during delivery fetus separates from placenta too early
  
• Diabetic mother
  
• Uterine rupture
  
• Mother has low blood pressure in mother during delivery
  
• Multiple deliveries
  
• Mother is over 35 years of age while delivering the baby.

The doctor attending to the mother experiencing fetal distress may follow any of the following:
Cesarean section
Episiotomy
Inducing labor with medication.
Vacuum extraction delivery - using a suction cup to pull the baby down the birth canal by placing the suction cup on the baby's head.
Making the mother lie down on her left side so as to ease the pressure off the blood vessels and thus the uterus.
Mother may be put on intravenous to improve fluid levels.
Mother may be put on additional oxygen to improve supply of oxygen to the fetus.

Epidural

The term epidural is often used as a short form for 'epidural anesthesia'. As a first step before administration of an epidural, an IV is given with relaxing medications. The next step is that the physician numbs a small area of the skin with numbing medicine. The physician then directs a small needle using x ray guidance into the epidural space. A small amount of contrast dye is injected to insure that the needle is properly positioned into the epidural space. Finally, a small mixture of numbing medicine or anesthetic and anti-inflammatory injection is injected.

Risk of epidural during childbirth

• A mother with low platelet count may make the placement of an epidural more risky.
  
• Sometimes due to weight problems, it becomes impossible for an anesthetist to find the epidural space.
  
• Epidurals cannot be administered if the mother is bleeding heavily or suffering from shock.
  
• It is observed that sometimes epidurals can lead to fetal distress and fetal malposition.
  
• Increased risk of forceps or vacuum extension, episiotomy and increased risk in cesarean section is observed because of epidural use.
  
• A study of breast feeding mothers conducted in 2006 reveals that mothers who received an epidural were more likely to experience problems in breast feeding during the first few days after delivery.