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What Are the First Signs of Hypoxia in Newborns?

Hypoxia, birth asphyxia, and hypoxic-ischemic encephalopathy (HIE) are all terms for a lack of oxygen to a baby before, during, or following birth. Lack of oxygen can cause serious birth injuries. Fortunately, birth injuries can often be prevented if medical professionals follow the standard of care by watching for the first signs of hypoxia. 

This information was compiled from government sources, educational non-profits, and medical experts.

To learn more about the first signs of hypoxia in newborns, keep reading.

Four Types of Hypoxia

There are four types of fetal hypoxia:

  • Acute Hypoxia
  • Subacute Hypoxia
  • Evolving Hypoxia
  • Chronic Hypoxia

The types of hypoxia describe the severity and duration of the condition.

Common Signs of Hypoxia in Newborns

Because hypoxia can lead to serious and permanent birth injuries, medical professionals should always be watchful for the signs of lack of adequate oxygen to the baby. This includes watching for the signs before, during, and after the child is born.

Three common signs of hypoxia include:

  • An erratic heart rate
  • A decreased heart rate
  • A lack of fetal movement

Medical professionals can observe the baby’s heart rate in the womb using a fetal heart monitor. 

Fetal Heart Monitoring

There are two ways to do fetal heart monitoring: internally and externally. 

External monitoring can be done using a Doppler ultrasound device. For continuous monitoring, the medical professional can attach an ultrasound probe called a transducer to the mother’s belly. This probe sends the sounds of the baby’s heart to a computer, where the rate and pattern are shown on a screen or printed on a paper. 

Internal monitoring can be done by affixing a thin wire (an electrode) to the baby’s scalp. The wire runs from the baby, through the mother’s cervix, and then to a monitor. This method gives better readings than external monitoring, but can only be used after the amniotic sac has broken and the cervix is open.

Whether internally or externally measured, a baby’s heart rate provides medical professionals with valuable information about whether the baby is receiving enough oxygen. An abnormal heart beat should be attentively monitored and treatment options should be evaluated. Medical professionals may order an emergency c-section if the baby is at risk of injury due to hypoxia. 

Common Factors that Cause Hypoxia

There are many reasons why a baby may not be receiving enough oxygen before, during, or following birth. Common factors can include:

  • Placental abruption
  • Uterine rupture
  • Compression of the umbilical cord
  • Umbilical cord knots
  • Prolapse of the umbilical cord
  • Mother’s low blood pressure
  • Mother’s low oxygen levels

And more…

Common Signs of Hypoxia at Birth Include

Common signs of hypoxia after birth may include:

  • Blueish or pale skin tone
  • Low heart rate
  • Poor / weak muscle tone
  • Poor reflexes
  • Weak / no cry
  • Difficulty breathing

Summary: the first sign of hypoxia is often an irregular heart beat: an erratic beat, or decelerations of the heart may be a sign of oxygen deprivation. Lack of movement may also be a sign of hypoxia. Medical professionals should always carefully monitor potential signs of hypoxia because a lack of oxygen can cause serious and permanent birth injuries, including HIE and Cerebral Palsy. 


Hypoxic-Ischemic Encephalopathy Clinical Presentation: History, Physical Examination. (2020). Emedicine.medscape.com. Retrieved 26 February 2020, from https://emedicine.medscape.com/article/973501-clinical#b2

Yatham SS, e. (2020). Types of intrapartum hypoxia on the cardiotocograph (CTG): do they have any relationship with the type of brain injury in the MRI scan in term babies? – PubMed – NCBI . Ncbi.nlm.nih.gov. Retrieved 19 March 2020, from https://www.ncbi.nlm.nih.gov/pubmed/31612740

About Brown Trial Firm

Getting help for a child with HIE or Cerebral Palsy can make a big difference. Because early intervention is often key to helping improve a child’s wellbeing, it’s important to act swiftly.

At the Brown Trial Firm, our birth injury attorneys can help you investigate your case, find answers to your questions, and determine whether you are entitled to compensation. 

We offer case reviews at no cost or obligation. Many birth injuries that cause cerebral palsy could have been prevented. Don’t wait, get help today. Call us toll free at +1 (866) 223-7465 or email us a [email protected].

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