Signs of Fetal Distress During Labor: What Parents Should Know
Mon 16 Feb, 2026 / by Robert Parker / Birth Injury
Recognizing the Signs of Fetal Distress During Labor
During labor and delivery, the medical team’s most important responsibility is monitoring the health and safety of both mother and baby. Fetal distress—a term used to describe signs that a baby is not tolerating labor well—requires prompt recognition and response. When healthcare providers fail to identify or act on signs of fetal distress, the result can be oxygen deprivation, brain damage, cerebral palsy, or even death.
At Parker & Parker Attorneys at Law, we have seen how a few minutes of inattention in the delivery room can change a family’s life forever. Understanding what fetal distress looks like—and what the medical team should do about it—can help families recognize when something went wrong.
What Electronic Fetal Monitoring Shows
Electronic fetal monitoring (EFM) is the primary tool used to assess a baby’s condition during labor. The monitor produces a continuous tracing that shows two key measurements: the fetal heart rate and the frequency and duration of uterine contractions. A normal fetal heart rate baseline ranges from 110 to 160 beats per minute. The tracing also shows accelerations (temporary increases in heart rate, which are generally reassuring) and decelerations (temporary decreases, which can indicate problems depending on their pattern and timing).
Nurses are responsible for watching the fetal monitor tracing continuously and alerting the physician to concerning patterns. This is one of the most critical duties in labor and delivery nursing, and failure to properly interpret the tracing or communicate findings to the doctor is a leading cause of preventable birth injuries.
Warning Signs on the Fetal Heart Rate Tracing
Certain patterns on the fetal heart rate tracing are recognized warning signs that the baby may not be getting enough oxygen. Late decelerations—drops in heart rate that begin after the peak of a contraction and return to baseline after the contraction ends—suggest the placenta is not delivering adequate oxygen to the baby. Variable decelerations are abrupt drops in heart rate often caused by umbilical cord compression, and while isolated variables can be benign, repetitive or prolonged variable decelerations are concerning.
Prolonged decelerations lasting more than two minutes, minimal or absent variability (the normal fluctuation in the heart rate baseline), and tachycardia (a sustained heart rate above 160 beats per minute) are all Category II or Category III patterns that require evaluation and potentially urgent intervention. A Category III tracing—characterized by absent variability combined with recurrent late or variable decelerations, bradycardia, or a sinusoidal pattern—is the most ominous and requires urgent evaluation and intervention, which often means an emergency cesarean delivery.
Other Indicators of Fetal Distress
Beyond the electronic monitor, other clinical signs can indicate a baby in distress. Meconium-stained amniotic fluid—when the baby passes its first stool before delivery—can indicate stress, and if the baby aspirates meconium during delivery, it can cause serious respiratory complications. Decreased fetal movement reported by the mother is another warning sign that should prompt further evaluation, including a non-stress test or biophysical profile.
During delivery itself, poor Apgar scores (the assessment performed at one and five minutes after birth), the need for immediate resuscitation, and umbilical cord blood gas values showing acidosis all confirm that the baby experienced significant oxygen deprivation during labor.
What the Medical Team Should Do
When signs of fetal distress are identified, the standard of care requires the medical team to take immediate steps. Intrauterine resuscitation measures include changing the mother’s position, administering oxygen, increasing IV fluids, and discontinuing Pitocin or other labor-stimulating medications. If the non-reassuring pattern does not resolve quickly with these interventions, preparation for emergency delivery should begin immediately.
The failure to act—whether through inattention to the monitor, misinterpretation of the tracing, poor communication between team members, or reluctance to “disturb” the attending physician—can constitute negligence when it results in preventable injury to the baby.
When Failure to Respond Becomes Malpractice
In birth injury litigation, the fetal monitoring strips are among the most critical pieces of evidence. Expert witnesses review the tracing minute by minute to identify when concerning patterns first appeared, what the medical team did (or failed to do) in response, and whether earlier intervention would have prevented the baby’s injuries. If the evidence shows that the baby was showing signs of distress and the medical team did not respond within the timeframe required by the standard of care, that failure can form the basis of a malpractice claim.
If your baby suffered a birth injury and you have questions about whether the medical team responded appropriately to signs of distress, Parker & Parker can review the records and help you understand your options. Call 309-673-0069 or contact us online.
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