Labor is a fine balance.

One of the best ways to know how your baby is doing during labor is through monitoring their heart rate. We want to see how your baby is handling each part of labor.

This is that fine balance we talk about- making sure that baby is handling the birthing process safely. Because your baby cannot verbally tell us how they’re handling the experience and there’s little we can see during the process, their heart rate gives us an incredible number of clues.

What is considered normal for a baby’s heartbeat?

Indications that everything with the baby is fine include:

• Heartbeat between 110 and 160 beats per minute.

• Heart rate increases when baby moves.

• Heart rate increases during contractions.

• Heart rate returns to normal after baby moves or after a contraction.

What is not normal for my baby’s heart rate?

Signs that there could be a problem include:

• Heartbeat is less than 110 beats per minute.

• Heartbeat is more than 160 beats per minute.

• Heartbeat is irregular

• Heartbeat doesn’t increase when baby moves or during contractions for an extended period of time.

So what happens if your baby's heart rate becomes less than ideal?

Any/all of the following may be a part of the scenario if the baby’s heart rate tells us there could be a concern.

-Your nurse will watch your vitals. She wants to see what’s happening and will be watching your monitors, taking your blood pressure, checking in to see how you’re feeling, etc.

-A Cervical Exam may be done to gather more information. Are you making significant change? Is  your baby about to deliver? Is there something happening with the baby’s position or the position of the umbilical cord?

-Oxygen + Fluids. Supplemental oxygen (by way of an oxygen mask) can help provide baby with more oxygen. IV fluids in this situation can help increase blood volume and keep blood pressure at a healthy rate.

-Amnioinfusion. This is a process by which fluid is pushed into the actual uterine cavity. If amniotic waters have been broken or if waters are low, inserting a continuous flow of fluid may help to correct that unstable heart rate in the event that your baby is getting their cord compressed.

-Changing Positions.  You might hear your nurse say, “I need to move you to your left side, your baby just isn’t liking it in this position.” It’s not uncommon to move positions every 20-30 minutes if you’ve had an epidural. A simple movement to the other side of your body, or leaning over the top of your inclined bed can give some relief to an unstable heart rate.

-Fetal monitoring. Your baby is being monitored from the outside, but they can also be monitored from  the inside. This type of monitoring is the most accurate picture we can get of how your baby is doing. This type of monitoring requires that your water is broken. An electrode is placed under the first layers of skin on your baby’s scalp.

-IV medication. Your provider may consider administering a medication to help stabilize your blood pressure or one to relax your uterus for a period of time. If you’ve been receiving Pitocin, your provider may decide to turn it off or down.

-Cesarean Section. This is usually the last option. In the event everything has been tried and the baby is still presenting with an unstable heart rate, a Cesarean may need to be performed.

It can be so scary to hear and see that your baby's heart rate is not having an ideal reaction to labor. It can be even scarier when extra medical staff rush into your room. Rest assured that they are rushing in there because they are watching your baby, and they are doing what is medically necessary to keep your baby safe. If your baby's heart rate is showing signs of distress, it’s likely that one of these or a combination of these techniques can be done to help.

Being informed in big moments like this can help you to know what is happening.

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Cre’shea Hilton is a Labor and Postpartum Doula and Childbirth Educator for Pacific Northwest Doulas