This list of terms is not exhaustive, but are commonly used in expert witness reports, letters of claim, letters of response, and medical notes. Not included are conditions of labour which are unlikely to relate to negligence and birth injury. I have not included words relating to injury to the mother, as its outside the scope of this list.
Medical Terms – Labour
When you are reviewing your medical notes, or trying to make sense of the expert witness reports, there are a lot of medical words you may not be familiar with.
Therefore, I have put together a summary of some of the words you may see, and a brief explanation of their meaning.
This section deals with labour and the others with pregnancy, and post delivery.
This section deals only with terms/words likely to be used with regard to negligence and are not extensive regarding the entirety of pregnancy. To add these would make the list too long.
If you have further questions relating to the terms used in any reports you receive, the person to ask is the solicitor dealing with your case.
Fetal Heart Rythms. Normally detected by CTG, but can be detected by Doppler
Bradycardia
NICE currently says the usual baseline is 110–160 bpm; below 100 is a red CTG feature, while 100–109 can be an amber feature depending on the rest of the trace. Persistent slow heart rate of the baby.
Tachycardia
NICE currently classifies a baseline above 160 bpm as a red feature.
Reassuring heart rate
A heart rate that looks normal and is reassuring
Non reassuring heart rate
A heart rhythm that is showing signs of fetal distress, but can return to a reassuring rhythm
Pathological heart rate
A rhythm which demonstrates a baby is in extreme distress and needs urgent delivery.
The terms reassuring, non reassuring and pathological are outdated terms, but I have left them as, to a lay person, they are more descriptive. Modern NICE assessment is based on the whole CTG — baseline, variability, decelerations, accelerations and contractions.
Amniotomy (Artificial Rupture of Membranes (AROM))
A small plastic instrument is used to break the membranes if necessary.
C Section/Caesarean Section
There are 4 categories of c section.
- Category 1: Immediate threat to the life of the mother or baby. Birth should take place as soon as possible and, in most situations, within 30 minutes of the decision.
Category 2: Maternal or fetal compromise which is not immediately life-threatening. Birth should take place as soon as possible and, in most situations, within 75 minutes.
Category 3: No maternal or fetal compromise, but early birth is needed.
Category 4: Birth is timed to suit the mother or healthcare provider.
- These time frames are NICE guidelines and all hospital trusts are expected to adhere to them. Not following these guidelines may be negligent.Guidance changes over time. When considering an historical birth, the guidance and standards applicable at that time are important; current guidance cannot simply be applied retrospectively. The changes can often be found via Google.
Cardiotocography (CTG) or electronic fetal monitoring (EFM)
Electronic monitoring during pregnancy and labour. Two pads are strapped to the abdomen and they record the baby’s heart rate, the mother’s heart rate and the contractions. Incorrect interpretation or response to an abnormal CTG can be an important issue in some birth injury claims. During some women’s labour, CTG monitoring should be continuous such as when oxytocin is used to induce or augment labour, NICE recommends continuous CTG monitoring. At other times there are recommendations to use continuous CTG readings or to use intermittent monitoring of the baby’s heartrate. Midwives are expected to adhere to these guidelines, and it may be negligent not to do so. The current NICE guidance specifically addresses this within the indications for continuous CTG
These are used if the pregnancy is high risk, or there have been issues throughout labour, or if concerns are developing. Failure to correctly interpret a CTG reading is one of the commonest reasons birth injury occurs.
Decelerations
Temporary episodes where the fetal heart rate falls below its baseline. NICE defines a deceleration as a fall of more than 15 beats per minute lasting 15 seconds or more. They are described as early, variable or late depending on their timing and characteristics in relation to contractions. Their significance depends on the overall CTG and the clinical circumstances.
Forceps Delivery
The use of curved metal instruments to deliver the baby. Forceps delivery should be performed by an appropriately trained and competent practitioner. Poorly performed they can cause injury
Failure to Progress in Labour, Prolonged Labour
There are not specified time periods that each stage of labour should last, as care is more individualised. However timescales should not be excessive, especially if the mother is becoming exhausted and the baby distressed. Should this happen the midwife/obstetrician are expected to take some action to expedite the birth.
Fetal Macrosomia (Large Baby)
Sometimes the baby is exceptionally large and will get stuck in the birth canal. Where possible this should be monitored beforehand and a c section offered where necessary. Women with gestational diabetes often have large babies, but ultrasound scans should also pick these up.
Fetal Blood Sample (FBS)
A small blood sample taken from the baby’s scalp during labour to assess the baby’s condition, traditionally including measurement of lactate or pH. It may be considered in certain circumstances when there are concerns about the CTG, but it is not appropriate in every situation and should not delay urgent delivery where immediate birth is necessary.
Hyperstimulation of the Uterus
Excessive or overly frequent uterine contractions, which can reduce the time available for the baby to recover between contractions. It can occur during induction or augmentation of labour, including with oxytocin. It can be concerning for the baby and requires appropriate assessment and management.
Individual Hospital Guidelines
Hospital Trusts often have individual guidelines which should follow NICE guidelines but they often have more detailed individualised systems. They can often be found on the hospitals maternity services websites.
Induction of Labour
Artificially inducing labour by various methods. A membrane sweep, pessaries, intravenous infusion to stimulate contractions, artificial rupture of membranes (AROM). When labour is induced with an IV infusion of oxytocin, continuous monitoring should always be done to avoid over stimulating the uterus.
Midwifery led Units/Birthing Centres
These units are as they say and do not have doctors routinely covering them. They are for straightforward births and the method of fetal monitoring is different from hospital births. The use of intermittent fetal monitoring is recommended. There are guidelines on when and for how long to listen to the heart rate at different stages of labour.
Intermittent fetal monitoring/Intermittent Auscultation (IA)
NICE recommend (deviation from these guidelines may be considered negligent)
- Listening to the baby’s heartbeat at regular intervals rather than continuously using a CTG. NICE recommends intermittent auscultation for women at low risk of complications, including during labour in appropriate birth settings. The timing and frequency of monitoring depend on the stage of labour and the woman’s individual circumstances. If concerns about the fetal heart rate arise, the monitoring should become more frequent and continuous CTG may be recommended. NICE says intermittent auscultation is offered to women at low risk and should be done every 15 minutes, or more frequently if needed.
For further information on NICE Guidelines during labour, follow the link away from this page
https://www.nice.org.uk/guidance/ng229/informationforpublic#
Placental abruption
A separation of the placenta from the uterine wall before the 3rd stage of labour. It can be mild with minimal effects, to catastrophic, with severe haemorrhage and infant mortality. Warning signs are constant abdominal pain with or without bleeding, and often abnormal fetal heart rate. Placental abruption can occur at times other than labour (which see).
During labour if the Placenta separates prematurely there will usually be severe pain and blood loss. The fetal heart rate will often become non reassuring. This event may be difficult to predict in labour if the abruption is very rapid, but if it is happening throughout part of the second stage, abnormalities of the fetal heart rate, changes in the feel of the abdomen, pain and bleeding will alert a competent midwife.
Shoulder Dystocia
This can occur particularly with larger babies, and if it has occurred in a previous birth and the baby is large, elective c section should be considered. However it is a recognised risk factor, but management is individual.
Umbilical Cord Prolapse
Normally the umbilical cord and placenta follow the baby through the birth canal. Rarely the cord goes in front or alongside the baby’s head or in other ways is compressed between the head and the pelvis, causing complete loss of oxygen to the baby. This must be recognised early and steps taken to expedite the birth.
Uterine rupture
Rarely the uterus will rupture during the second stage of labour, although it can rupture at any time. It causes a catastrophic blood loss and is a severe risk to the infant. Risk factors are hyperstimulation of the uterus with infusions of oxytocin, or vaginal birth after a c section.
Vaginal Birth after Caesarean (VBAC)
With a previous caesarean section, some women are offered VBAC and an opportunity to labour naturally. The main risk, which is rare, is the uterus will rupture along the line of the old uterine scar. The reasons for the previous c section and the risks must be explained in full to the mother. This in informed consent
Please remember that clinical guidance changes over time. If you are looking at an older birth, the guidance and professional standards that applied at the time are relevant to the assessment of the care provided. Current guidance should not automatically be applied to an historical case.
NICE Guidelines reviewed 2026
Source: NHS, NICE, RCOG
