The gentlebirth.org website is provided courtesy of
Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA

Single Umbilical Artery - Two-Vessel Cord

The good news about a single umbilical artery is that the babies usually do very well during pregnancy.  The fetal support system (placenta and umbilical cord) is designed to provide plenty of oxygen for the baby through the significant stresses of labor and birth, which is much more than the stresses of a normal pregnancy.

However, the stresses of labor and birth are significantly greater, which is why babies are monitored during labor to assess their continuing well-being.  In particular, the stresses during pushing can be significant.  It is possible that these stresses may be too much for the baby, which could cause fetal distress and require a cesarean section for a safe birth of the baby.  This does make the postpartum recovery significantly more difficult, and it is harder for a new mom to mother her new baby as well as she would like when she is also recovering from major surgery.

Google Search for information about Single Umbilical Artery

Women's Health Information - Single umbilical artery  - fairly reassuring

So, here are some things you can do that will increase the safety for the baby during pregnancy, and some things you can do during late pregnancy,  labor and birth to increase the chances of a safe vaginal birth.

These are simply general ideas that are worth considering.  You need to discuss your options with your care provider to choose treatments that are best for you and your baby.

Pregnancy

Ensure Adequate amniotic fluid levels by drinking lots of water, and getting good levels of salt and trace minerals.  (Deep water immersion also helps to increase amniotic fluid levels.)

Learn exactly where your placenta is - ask your provider to map it out on your body.  In particular, if you have an anterior placenta, you need to know exactly where it is so you can make sure that the baby's weight is not placed on this area, since that can compress the umbilical cord and reduce oxygen to the baby.  Most placentas are fundal (i.e. at the top of the uterus) or posterior (towards the mother's spine), and most women do not get into positions that put the baby's weight on these areas.

Late Pregnancy

Induction

If your provider believes that induction may become necessary, request one day of low-dose pitocin for ripening the cervix if necessary, followed by a good night's sleep at home, or, if you have time, a couple days to rest and allow the cervix to continue the ripening started by the pitocin nudge.

When pitocin is started for the official induction, insist on a dose that is just low enough to START labor, and then allow the body to increase the pace of labor naturally, which will eventually happen once you get past 5 cm.

Or, if induction becomes suddenly necessary, and your provider does not want you off continuous monitoring, request oral low-dose Cytotec induction.  Especially if your cervix is not ripe, this will help ripen the cervix and can initiate a "natural" labor that is easier on the baby than a pitocin-driven labor.  Given your higher-risk status, it might make sense to request a lower dose of oral Cytotec than stated in the studies.

Labor

Remain as relaxed as possible; this minimizes the mother's own use of oxygen.

Decline Rupture of Membranes - more amniotic fluid cushioning the umbilical cord will prevent cord compression that reduces the oxygen transport through the umbilical cord.

During labor, maintain supported upright positions - this keeps the weight of the baby's body off the umbilical cord and allows maximum transport of oxygen through the single umbilical artery.  Upright positions also facilitate progress by putting the baby's weight on the cervix and facilitating the baby's movement into and through the pelvis; supported positions minimize the mother's use of oxygen in her voluntary muscles.

Remember to keep baby's weight off the placenta.

Ideally, labor in warm water.  Even if your birth attendant isn't willing to have the baby born in water, you can still spend most of your labor in water.  The warm water around your belly will increase your bloodflow to the placenta and improve placental oxygenation, which increases the baby's oxygen levels.  Laboring in water is also excellent pain relief, which will make it much easier to avoid an epidural.  Also, the buoyancy of the water allows women to stay in upright positions without using a lot of energy.  She can be very relaxed, sitting on a stool in the water or kneeling against the side of the tub.  The baby's buoyancy also reduces the likelihood of cord compression of any type.  Ideally, you could be in a real birthing tub rather than a regular bath tub since the deeper birthing tubs offer substantial advanrages.  If it's not possible to labor in a warm tub, try a warm shower for both the warmth and relaxation.

Avoid epidurals - Epidurals often lower the mother's blood pressure, which will decrease the amount of oxygen that is transported to the
placenta.  An epidural also limits your ability to remain upright.  If you do have an epidural in place, avoid lying completely on your side.  Epidural medication is moved from the injection site to the nerves by gravity, so you may need to recline slightly.  If necessary, support your shoulders and hips on an extra layer of towels to keep your weight off the belly where the placenta is.

If the fetal monitors show evidence of reduced oxygenation to the baby, consider requesting an IV unless the mother has been very well hydrated during labor.  Increase warmth around the uterus, and make sure the mother's hards and feet are warm.   [Use homeopathic carbo veg. 200C (if available) and arnica for potential fetal distress.]