All You Need to Know About Early Decelerations

Throughout your pregnancy, you’ll be monitored closely – and at every appointment, your midwife, OB or doctor will listen to the baby’s heart rate. This is even more important during labor itself, as contractions can have an impact on the baby’s heart rate. So, during your labor, your healthcare provider will probably be checking the baby’s heart rate fairly regularly.

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What is fetal deceleration?

Decelerations are temporary changes in the fetal heart rate. There are different types of fetal decelerations, and one is called an early deceleration. But what are early decelerations? Are early decelerations bad? Below, we explain:

Early decelerations: These are generally normal and not harmful. They tend to happen right before the peak of a contraction. They’re thought to happen mostly when the baby’s head is compressed, more so when they’re entering the birth canal or if they’re breech and the uterus is squeezing the head.

Late decelerations: They can be a possible sign of the baby not being okay. These decelerations begin after the peak of the contraction, or when the contraction is complete. They are shallow dips in the heart rate that look similar to the contraction that caused them.

Sometimes they’re nothing to worry about, as the baby’s heart rate quickly recovers to a normal heartbeat – known as an acceleration. However, late decelerations can indicate that the baby isn’t getting enough oxygen, especially if there is little change after a deceleration. If this happens, the doctor will advise you about what’s going on, and discuss the best course of action – including possibly (but not always) a caesarean section.

Variable decelerations: These can also be a possible sign of the baby not being ok or distressed. They are irregular dips in the baby’s heartbeat, and look dramatic in the recordings. These decelerations can happen when the umbilical cord is compressed for a short amount of time. As the cord is important to make sure that the baby receives enough oxygen, variable decelerations can be a sign that the baby’s blood flow is reduced.

Medical professionals can decide if these early decelerations are harmful based on all the information they gather during labor. They may advise a caesarean if the variations are extreme and early on in labor. If there are accelerations following the deceleration, this is often considered normal and they’ll monitor the situation as usual.

How do early, late and variable decelerations get monitored?

Just to reassure you – how your healthcare providers monitor the baby’s heart rate is completely painless, but it might feel a little strange or uncomfortable. It is routinely done during labor on all mamas-to-be because there are very few risks associated with it.

There are two ways early, late and variable decelerations can be monitored:

• Externally: Either a hand-held doppler is used to count the heart rate during a contraction and for 30 seconds afterwards or a transducer is held on the mama-to-be’s tummy with a belt, and it is connected to a FHR monitor. The monitor gives a reading on the fetal heart rate on a print-out strip of paper.

• Internally: An electrode is clipped to the baby’s scalp with a connection to a FHR monitor. For this to happen the cervix needs to be slightly dilated and the waters to have broken so that the baby’s head can be reached.

Hearing your baby’s heartbeat can be reassuring when you’re in labor, but if you’re worried or don’t feel you understand what’s going on at the time, please talk to your doctor or midwife, who can explain the process and what the information means.

And please remember that lots of things are being monitored while you’re in labor, so a variety of factors will help the professionals determine how you and your baby are doing.

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