Diagnosing Birth Asphyxia | Action Medical Research | Children's Charity | Children's Charity

Birth asphyxia: diagnosing fetal distress during labour

This research was completed on 29 February 2016

Published on 10 February 2012

Oxygen deprivation during birth: identifying babies at risk

Midwives and doctors often monitor babies’ heartbeats during childbirth to find out how they are coping and check they are getting enough oxygen. The equipment they use, which was introduced nearly 50 years ago, produces a chart that can be difficult to interpret. Sometimes it is hard to tell how a baby is doing, and whether they should be delivered urgently by emergency caesarean section. Professor Christopher Redman, from the University of Oxford, is investigating whether computerised interpretation of charts could help.

What is the problem and who does it affect?

Worldwide, nearly one quarter of babies who die within a month of birth lose their lives to a problem called birth asphyxia – oxygen deprivation and a reduced blood supply to the brain around the time of birth that lasts long enough to be harmful.1,2 Babies who are short of oxygen during childbirth are in immediate danger, and must be delivered urgently, by an emergency caesarean section, for example.

The first clue that a baby is in trouble during childbirth often comes from abnormalities in the baby’s heartbeat. “Sometimes it is difficult to interpret changes in a baby’s heartbeat, which leads to uncertainty over whether a baby actually has birth asphyxia,” explains Professor Redman. “In this situation, doctors often make a fail-safe decision to intervene, and deliver the baby by caesarean section, thinking it is better to be safe than sorry. Often though, it turns out that the baby was actually fine and the caesarean – a major operation for the mother – was unnecessary.”

Sadly, in some other cases, babies’ problems are not spotted soon enough. “Birth asphyxia kills 250 babies each year in the UK and babies who survive can be left with life-long disabilities such as cerebral palsy,” explains Professor Redman.3

What is the project trying to achieve?

The equipment used during labour to check how well a baby is coping produces a paper chart displaying two lines – one showing the baby’s heartbeat and another showing the mother’s contractions. “The equipment generates yards of paper,” explains Professor Redman. “The pattern it displays of the baby’s heartbeat can be complex. Doctors and midwives have to assess this pattern by eye, which can be very difficult. Even experts can disagree about whether or not the chart suggests the baby is in trouble.”

“We are investigating whether computers can do a better job of interpreting the baby’s heartbeat, deciding whether the baby has birth asphyxia and recommending whether an urgent delivery by caesarean section is necessary,” continues Professor Redman. “Improving this decision-making process could stop healthy babies from being born by unnecessary caesareans and protect babies who do have birth asphyxia from death and disability.” The team is using data collected on nearly 30,000 births.

What are the researchers’ credentials?

Project LeaderProfessor S Kennedy
Project team
  • Dr S J Payne
  • Dr A E Georgieva
  • Mr A Papageorghiou
  • Dr A E Georgieva
  • Professor C W G Redman
LocationNuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital and Institute of Biomedical Engineering, University of Oxford
Other locations
  • Fetal Medicine Unit, St Georges Hospital, London
Duration36 months
Grant awarded10 November 2011
Start date1 May 2012
End date29 February 2016
Grant amount£133,262.00
Grant codeGN1946
AcknowledgementsThis project supported by a generous grant from The Henry Smith Charity.

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Professor Redman has been researching ways to monitor the health of babies within the womb for over 30 years. He has already successfully developed a computerised system that interprets the heartbeats of babies during pregnancy, before labour begins. This system, the first of its kind, has been used worldwide for more than 20 years.


  1. Lawn JE, Cousens S, Zupan J. 4 million neonatal deaths: When? Where Why? Lancet 2005; 365(9462); 891-900.
  2. Bryce J, et al. WHO estimates of the causes of death in children. Lancet 2005; 365:1147-52.
  3. CMACE, Perinatal mortality 2008, London 2010.
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