Decelerations of the fetal heart rate are a common part of the birth and delivery process. In this article, we’ll define the term “deceleration” and explain how it relates to birth injury law.

Key Takeaways

• Decelerations are a temporary decrease of the fetal heart rate which is normally between 120 and 160 beats per minute
• There are three types of decelerations: early, late, and variable 
• Causes of decelerations vary based on the type and include compression of the fetus’s head, a decrease in blood flow to the placenta, and compression of the umbilical cord 
• Declarations can be treated through repositioning, IV fluids, supplemental oxygen, medications, and emergency delivery 

What Are Decelerations?

Decelerations are a temporary decrease in the fetal heart rate. They are able to be identified during fetal electronic heart rate monitoring, which is used to record the fetus’s heartbeat and the birthing parent’s contractions before and during labor. The baseline fetal heart rate is usually between 120 to 160 beats per minute. With decelerations, it can drop about 40 beats per minute below the baseline. 

Types of Decelerations

There are three categories of decelerations classified based on their shape and timing.

• Early decelerations - These are benign and uniform in shape, beginning near the onset of a uterine contraction. Their lowest point occurs at the peak of the contraction. Because they do not affect fetal oxygenation, early decelerations do not require treatment. 
• Late decelerations - These are also uniform in shape, with their onset and return to baseline gradual. However, they often begin just after a contraction, with their lowest point occurring after the contraction’s peak. Late decelerations are associated with conditions of the fetus and birthing parent. 
• Variable decelerations - The most common type of decelerations, these typically occur during the first and second stages of labor and vary in shape, duration, and intensity. They may not have a constant relationship with uterine contractions. 

Causes of Decelerations

The causes of deceleration vary based on the type. 

• Early decelerations - These are caused by the compression of the fetus’s head during a uterine contraction, which can bend the neck and cause vagal stimulation. 
• Late decelerations - These are caused by uteroplacental insufficiency, a decrease in the blood flow to the placenta which reduces the amount of oxygen and nutrients transferred to the fetus. This can be caused by a number of circumstances including low parental blood pressure, dehydration or anemia of the birthing parent, rapid contractions, placental abruption, and fetal hypoxia. 
• Variable decelerations - These are caused by compression of the umbilical cord. Decreased amniotic fluid is associated with more frequent variable decelerations. 

Treatment of Decelerations

To treat decelerations, immediate measures must be taken to prevent fetal hypoxemia and restore uteroplacental blood flow. Common treatments include:

• Repositioning the birthing parent to relieve pressure on the vena cava and increase blood flow to the heart
• Administration of IV fluids to increase blood volume and blood flow
• Supplemental oxygen to increase the concentration of oxygen transferred across the placenta to the fetus
• Medications to relax the uterine muscles and decrease the frequency of uterine contractions, allowing more blood flow to the uterus
• Emergency delivery via cesarean section

Decelerations and Birth Injury Law

Some fetal decelerations are harmless, while others are indicative of potential issues. It is crucial that medical professionals properly monitor the fetus in order to track the heart rate and identify potentially problematic decelerations. With late decelerations, doctors must act quickly in order to prevent birth injury to the baby from low oxygen and blood flow. 

When healthcare professionals fail to properly monitor fetal heart rate and promptly respond to late decelerations, it may be considered negligence. And when it causes a birth injury, it can fall under the umbrella of medical malpractice. 

If your baby experienced a birth injury because of a medical professional’s improper response to decelerations, you may be eligible for compensation. It is recommended that you speak to an experienced birth injury attorney who will be able to consult with you on your case.