Experiencing a fever during labor can be a source of concern. While it might indicate an underlying issue, an elevated temperature during childbirth does not always point to severe complications. Nevertheless, it warrants prompt medical evaluation to ensure the well-being of both the laboring person and the baby.
Understanding Fever During Labor
A fever during labor, often termed intrapartum fever, is defined as a maternal body temperature of 100.4°F (38°C) or higher. This temperature threshold initiates closer monitoring and potentially medical interventions. While some temperature elevation can occur due to the physical exertion of labor, a sustained fever above this level is considered abnormal.
Intrapartum fever is not uncommon, with reported prevalence rates ranging from approximately 1% to 10% of deliveries. Healthcare teams are equipped to manage such situations.
Common Causes of Labor Fever
One primary infectious cause of fever during labor is chorioamnionitis, an inflammation of the fetal membranes and amniotic fluid. This condition arises when bacteria from the vagina ascend into the uterus, particularly after the amniotic sac has ruptured. Risk factors include prolonged rupture of membranes, long labor, frequent vaginal examinations, and certain vaginal or sexually transmitted infections.
Epidural anesthesia can also lead to a non-infectious fever in laboring individuals. This phenomenon, sometimes called epidural-related maternal fever, affects approximately 15% to 25% of individuals who receive an epidural. The exact mechanism is not fully understood, but theories suggest it may involve a sterile inflammatory process or altered thermoregulation due to the epidural’s effect on sympathetic nerves.
Dehydration during prolonged labor can also contribute to an elevated body temperature. Insufficient fluid intake compromises the body’s ability to regulate temperature. Other less common causes of intrapartum fever include general infections not directly related to the uterus, such as urinary tract or respiratory infections, or the use of certain medications like prostaglandin drugs for labor induction.
Potential Outcomes for Mother and Baby
A fever during labor can have several implications for the laboring parent. It may lead to decreased uterine contractions, potentially prolonging labor and increasing the likelihood of interventions such as operative vaginal delivery or a cesarean section. There is also an increased risk of postpartum infections and, in some cases, a higher chance of postpartum hemorrhage.
For the baby, maternal fever can lead to several concerns, even if not caused by an infection. Fetal tachycardia, an elevated fetal heart rate, is a common finding. Babies born to mothers with intrapartum fever may also have lower Apgar scores immediately after birth.
Maternal fever can increase the baby’s risk of needing breathing assistance after birth and may lead to admission to the neonatal intensive care unit (NICU). If an infection is present, there is a risk of vertical transmission to the fetus, potentially leading to neonatal sepsis, meningitis, or pneumonia shortly after birth. While generally transient, maternal fever has been linked to a higher risk of neonatal seizures, hypotonia, and, in rare instances, longer-term neurological complications like cerebral palsy.
Medical Management and Expectations
When a fever is detected during labor, healthcare providers initiate steps to determine the cause and manage the condition. Continuous monitoring of the laboring person’s temperature and the baby’s heart rate is standard practice. This close observation helps assess the severity of the fever and the baby’s response.
Diagnostic tests are performed to identify the underlying cause. These may include blood tests, such as a complete blood count and C-reactive protein, to look for signs of infection. Blood cultures might also be collected to identify specific bacteria if an infection is suspected, ideally before antibiotics are administered. A urine test can also be done to rule out a urinary tract infection as a source of the fever.
Treatment approaches vary based on the suspected cause. If an infection is believed to be the reason, broad-spectrum antibiotics are administered promptly to treat the mother and reduce the baby’s infection risk. Other supportive measures include intravenous fluids to combat dehydration and lower body temperature, along with fever-reducing medications like acetaminophen. Healthcare providers communicate concerns about fever and any changes in condition, ensuring appropriate interventions for the best possible outcomes.