Blog

In this episode of the Healthful Woman podcast, Dr. Nathan Fox speaks with Devon about her pregnancy and her son’s diagnosis of fetal growth restriction. In part one of her birth story, Devon shares how a routine ultrasound uncovered a growth concern that would shape the rest of her pregnancy and lead to a tense, fast-moving delivery.

Devon’s Story

Devon, who works in international public health focused on women’s and newborn health in sub-Saharan Africa and Southeast Asia, was no stranger to pregnancy risk. Her sister is an OB-GYN, and Devon had already experienced a miscarriage before conceiving her son. So when a routine ultrasound at 21 weeks showed her baby measuring smaller than expected — in the 19th percentile for weight — she started paying close attention.

The concern didn’t resolve itself. By 32 weeks, her OB and her maternal-fetal medicine (MFM) specialist were tracking measurements that called for continued monitoring. Then, at 36 weeks, the picture became clear: her baby’s estimated weight had dropped to the 5th percentile, with abdominal circumference below the 1st percentile. Blood flow through the umbilical cord was abnormal, and her amniotic fluid was low. Her care team made the call — it was time to deliver.

Devon recalls asking her MFM specialist whether she could delay her induction by a few days for a concert she’d been looking forward to. The answer was direct: “I don’t think you’re fully appreciating that.” This wasn’t a diagnosis that could wait.

The induction itself was anything but straightforward. Cervidil brought on contractions within hours, and the night that followed was marked by back-to-back contractions and repeated fetal heart rate decelerations. Her medical team performed an amnioinfusion to ease pressure on the umbilical cord, started Pitocin the next morning, and placed an epidural in case an emergency cesarean became necessary. When her water broke at just 1 centimeter dilated, everything moved quickly — Devon reached full dilation and delivered after roughly seven minutes of pushing.

Her son was born with the umbilical cord wrapped once around his neck. His Apgar scores were 3 at one minute and 6 at five minutes, and he needed positive pressure ventilation before breathing on his own at two and a half minutes. After a brief moment of skin-to-skin contact, he was taken to the NICU. As one NICU doctor told Devon in that moment: “The best thing for him right now is you.”

Understanding Fetal Growth Restriction

What Causes FGR and How It’s Monitored

Fetal growth restriction (FGR), sometimes referred to as IUGR, means a baby isn’t growing at the expected rate in the womb — often due to issues with placental function, umbilical blood flow, or maternal health conditions. It’s typically identified through serial ultrasounds that track estimated fetal weight and abdominal circumference against expected percentiles for gestational age. Because measurements can vary somewhat between providers, MFM specialists often layer on additional tools, like Doppler studies of umbilical artery blood flow and amniotic fluid assessments, to build a fuller picture of how well a baby is tolerating the pregnancy.

When Growth Restriction Changes the Delivery Plan

When FGR is confirmed alongside signs like abnormal umbilical blood flow or low amniotic fluid, the risk of complications during labor rises, and doctors often recommend earlier delivery. Labor itself may require closer management: continuous fetal heart rate monitoring, interventions like amnioinfusion to relieve cord compression, and a lower threshold for emergency cesarean if the baby shows signs of distress. It’s also common for growth-restricted babies to need NICU support immediately after birth, as Devon’s story illustrates.

Learn More

Listen to this episode of the Healthful Woman podcast to hear Devon’s full story, and check back next week for part two of her journey. If you’re navigating a high-risk pregnancy or have questions about your baby’s growth, Carnegie Imaging for Women provides specialized maternal-fetal medicine care and support throughout every stage of pregnancy. Contact Carnegie Imaging for Women through the online contact form to schedule an appointment.

Carnegie Imaging for Women blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!