Every parent-to-be dreams of a simple, easy labour and delivery. They’ve spent the last nine months working to keep themselves and their baby-to-be safe and healthy. They eat healthily, they work out, they cut out sugar and bad habits, and they attend their prenatal doctor’s appointments, all in an effort to ensure that their baby is as healthy as it can be.
But once it comes time to bring the baby into the world, there are potential complications that can affect mom and baby. According to publications, there are still so many moms every year who experience significant complications. The numbers are high, and many of the cases are preventable.
So while these numbers might be a bit intimidating, if moms-to-be are well prepared with information, they can avoid a lot of these complications and be prepared to deal with these complications if they do arise. And thankfully, if mom is prepared she can rest easy knowing that her doctors, midwives and nurses are ready to deal with all possible outcomes. Here, I’ve rounded up 20 birth complications that, while rare, some mom might experience when they go into labour, and should speak to their team about before birth.
20 Breech Position
With 1 out of 15 full-term babies in the United States born in breech position, this birth complication is one of the more common complications that hospitals see. Breech position or a breech birth occurs when a baby fails to move into a head-first position before delivery. Instead, the baby’s backside or their feet are positioned to be delivered first.
If you are presenting breech when you are in labour, most doctors will not attempt a natural birth. Instead, they will recommend a Caesarean section aka a belly birth.
But don’t fret! If your baby is presenting breech there are a few different ways to try to move a breech baby into position before delivery At around 37 weeks, your doctor will try to help move the baby into the correct position. They may suggest chiropractic care as it can reduce the stress on a woman’s uterus and the surrounding ligaments. Dr Larry Webster, D.C., of the International Chiropractic Pediatric Association, created the Webster Breech Technique and it has seen an 82% success rate when performed in the 8th month.
You can also try the Breech Tilt technique. Grab a few pillows and raise your hips 12” off the floor for 10-15 minutes, 3 times a day. Do this on an empty stomach, when the baby is active for the best results.
19 Blocking The Baby's Path Out
A condition affecting the placenta, placenta previa occurs when the baby’s placenta is not located in front of or behind the baby. Instead, the placenta is partially or completely covering the mother’s cervix. The cervix is the outlet for the uterus so covering it can cause some issues during pregnancy and delivery.
If you have been diagnosed with placenta previa, you may find that you bleed throughout your pregnancy and even more so throughout your delivery. There are some things that your doctor will most likely tell you not to do during your pregnancy. Say buh-bye to being close to your partner, taking runs and any jumping jacks you were planning.
Odds are you will need a C-section when it comes time to deliver your baby is the placenta previa hasn’t resolved itself before going into labour.
18 Shoulder Dystocia
Only happening in 0.3-1% of all births, shoulder dystocia is a very uncommon condition. Shoulder dystocia happens when, during delivery, the head of the baby is delivered but the anterior shoulder of the baby doesn’t pass below the pubic symphysis. Basically, once your baby’s head had been delivered, they get stuck at their shoulders. It is considered a very serious obstetric emergency.
Shoulder dystocia is not something that can be easily predicted. It can happen if the baby isn’t in the best position to be delivered, if the baby is big (although most big babies don’t get stuck) or if you are not in the best position to birth baby’s shoulders.
If your midwife or doctor suspects your baby’s shoulder is stuck, the room will quickly fill with people. But don’t panic. They will likely get you to try different birthing positions to try to give baby more room in your pelvis to be delivered. In very, very rare cases, the doctor may need to break your baby’s collarbone to get them free. Although this sounds painful and scary, your baby’s bone will heal. And remember this is a worse case scenario.
17 Prolapsed Umbilical Cord
Prolapsed umbilical cord occurs when the umbilical cord is delivered before the baby. When this happens, the baby’s body can actually put pressure on the cord and cut off their own blood supply. Occurring in approximately 1 in every 1,000 deliveries, prolapsed umbilical cords present in two ways: overt and occult prolapse.
An overt prolapse occurs when your water has already broken and the umbilical cord comes out before the baby. This often happens in conjunction with a breech presentation, but can also happen when your water breaks prematurely or if the baby hasn’t moved far enough down in the pelvis. This kind of prolapse requires an immediate C-section.
An occult prolapse happens when your water hasn’t broken yet, and the cord is in front of or beside the baby. An occult prolapse is usually diagnosed by an abnormal fetal heart rate. Usually changing mom’s position can correct the issue.
16 Nuchal Cord
One of the most sensationalized birth complications that we’ve all heard about via movies and television is a nuchal cord. Don’t recognize the term? A nuchal cord is when the umbilical cord is wrapped around the baby’s neck. It happens in about one-fourth of every delivery, meaning doctors are well versed in how to help babies in this situation and deliver them unharmed.
While it can sometimes be identified before labour begins, doctors won’t do anything. Doctors are constantly checking for a nuchal cord as they deliver the baby. If the doctor does feel the cord wrapped around baby’s neck, they can usually slip the cord over baby’s head. If they are unable to do so because it is too tight, the cord may be cut before the baby’s shoulders are delivered.
15 Pregnancy Induced Hypertension or Preeclampsia
Developing in the 20th week of pregnancy, preeclampsia is characterized by high blood pressure. It’s a serious condition that needs to be managed throughout pregnancy but also adds an extra complication when mom goes into labour.
Odds are that you will be monitored very, very closely throughout your pregnancy. Your doctor may decide to induce your labour instead of waiting for it to occur naturally. Odds are you will be able to avoid a C-section, but if your doctor decides to induce before 30 weeks, you will have to have a C-section as your cervix won’t be ready for delivery.
If your hypertension gets worse, there are a lot of life-threatening complications that can arise, including bleeding in the brain, seizures or coma. As long as you are working closely with your doctor, you should be able to avoid all of these scary complications.
14 Meconium Aspiration Syndrome
Meconium is the first stool that a newborn baby will pass soon after birth. It is passed before the baby has had a chance to digest breastmilk or formula. But sometimes, babies pass meconium while they are still inside the uterus. Usually, this only happens when the baby is under stress aka their supply or blood and/or oxygen begins to decrease. Doctors often attribute this to issues with the placenta or the umbilical cord.
Meconium can be breathed in by the baby into their lungs. This can happen when the baby is still in the uterus, or when they are delivered but covered in amniotic fluid. The meconium can block the baby’s airway right after birth. This can cause breathing problems in the baby.
If it is discovered that your baby has passed meconium and you aren’t in labour, you will likely be required to have an emergency C-section to get baby out as quickly as possible.
13 Perinatal asphyxia
Perinatal asphyxia happens when your baby isn’t breathing normally just before, during, or after delivery. If your baby is born quiet or limp, doctors will quickly check for any issues in breathing and get to work to ensure that baby is breathing normally.
If the baby isn’t breathing because of meconium aspiration syndrome, doctors and nurses will work to suction out the fluid. For other reasons, doctors will need to respond to the specific obstacles they are facing. The baby may be put on a respirator and if doctors are worried about potential brain damage, they may be put into a hyperbaric oxygen tank to attempt to reverse any brain damage by exposing them to 100% oxygen environment.
12 Cephalopelvic Disproportion
Cephalopelvic Disproportion is another birth complication that is reserved for babies who are weighing in on the bigger side. The issue arises when baby’s head or body is too large to fit through your pelvis. It is actually a very rare condition, but a lot of cases of “failure to progress” during labour are (incorrectly) labelled as CPD. When CPD is diagnosed accurately, the best way for mom and baby to move forward is via C-section.
There are a few different causes of CPD, such as hereditary factors, diabetes in the mother, small or abnormally shaped pelvis, and abnormal fetal position. A lot of these factors cannot be changed or affected beforehand, but CPD can be diagnosed before delivery.
Ultrasounds that predict the size of a baby can be used to diagnose a potential case of CPD before it becomes an issue, but most cases of CPD can be diagnosed beforehand.
11 Uterine Rupture
A uterine rupture is an actual tear in the uterus, and it most often occurs at the site of a previous C-section incision. A complete rupture means that the tear goes through all the layers of the uterine wall. It can be very dangerous for mom and baby. The good news is that uterine ruptures are very rare. When they do happen, it is most often during labour but they can happen before the onset of labour.
If a uterine rupture occurs, you will need to have an emergency C-section. Most often the uterus will be repaired after the baby is delivered. But if the damage is severe and the bleeding cannot be controlled, you will need a hysterectomy. You will also be given IV antibiotics and may need a blood transfusion as well.
10 Rapid Labour
While it might seem like a dream come true, having a quick labour and delivery can have some unforeseen complications for you and for your baby. On average, labour lasts for 6-18 hours. Rapid labour or precipitous labour can last for as little as 3 hours and is typically less than 5 hours,
There are several factors that may make you more susceptible to rapid labour. You may have an efficient uterus with strong contractions, an extremely compliant birth canal or a history of prior rapid labour.
The biggest difficulty moms face with rapid labour is the emotional toll it takes. Your birth plan will probably be thrown out the window, and you’ll have a hard time using your previously planned coping strategies. You may also be worried that you might not have time to make it to the hospital, and if you do, you might not have enough time to be given an epidural.
9 Occipito-Posterior Position
We’ve talked about breech presentation already, but there are other types of malposition that can affect labour and delivery. Occipito-posterior position, or back labour, is the most common malposition: it occurs in 5.2% of all deliveries.
In this position, the baby’s head is initially engaged normally, but then they rotate towards the back rather than anteriorly. It can happen because of a flat sacrum, a poorly flexed head or weak uterine contractions that haven’t pushed the head into the pelvis with enough strength to rotate the head properly.
Occipito-posterior position can result in a really long labour, sorry mom-to-be! You and the baby will be monitored very closely and an epidural is recommended as back labour can be even more painful than normal labour.
8 Occipito-Transverse Position
A third malposition that can affect moms when they go into labour is the occiput-transverse position. In this malposition, the baby’s head initially engages correctly but then fails to rotate and stays in the transverse position.
If you are still in the early stages of labour or have not gone into labour yet, you can try standing up and swaying, lunging and pelvis tilts to encourage baby to get into the correct position for delivery.
If you’ve reached the second stage of labour (there are three!), baby’s head will need to be manually rotated with forceps and delivered using vacuum extraction. Alternatively, you will need to have an emergency C-section to safely deliver the baby.
7 Baby Placement Abruption
When the placenta partially or completely separate from your uterus before your baby is born, this is called placental abruption. It is a serious condition which will require immediate attention from your doctor. It can deprive the baby of oxygen and causes severe bleeding that is dangerous for both mom and baby. Placental abruption happens in about 1 in every 150 pregnancies and is most common in the third trimester.
If you have a placental abruption, you’ll need to deliver your baby right away if you are near your due date.
While the cause of most cases of placental abruption is unknown, there are some risk factors that make the condition more common. If you’ve had an abruption in a previous pregnancy, have preeclampsia, have a blood clotting disorder, have too much amniotic fluid, had early bleeding in your pregnancy or are carrying multiples, a placental abruption is more likely to occur.
6 Low Amniotic Fluid or Oligohydramnios
Amniotic fluid is part of your baby’s life support system. It helps in the development of muscles, limbs, lungs and digestive system and also protects the baby as they grow. Oligohydramnios is a condition that means you do not have enough amniotic fluid. Throughout your pregnancy, doctors will monitor the amount of amniotic fluid in your uterus. About 8% of pregnant women have low levels of amniotic fluid, and only 4% are officially diagnosed with oligohydramnios.
If you are diagnosed late in your pregnancy, you may be given an amnio-infusion during labour through an intrauterine catheter. This allows doctors to add fluid to help pad the area around the umbilical cord during delivery. They may also perform an amniocentesis prior to delivery to add fluid to the uterus.
5 Vasa Previa
When one or more blood vessels from the placenta or umbilical cord lies across the entrance to the cervix, the condition is called vasa previa. This condition often isn’t detected until labour begins because the blood vessel may rupture when your water breaks. It only occurs in 1 in every 2,000 pregnancies but can be very dangerous for mother and baby.
There are several management strategies that ensure a safe delivery of the baby and minimize the damage which can be caused by ruptured blood vessels. Your doctor should keep a close eye on your cervix, and they may suggest a scheduled C-section.
4 Amniotic Fluid Embolism
An amniotic fluid embolism occurs when some of the amniotic fluid enters the woman’s bloodstream and causes a serious reaction in mom. It can actually damage the lungs and heart of mom-to-be and cause excessive bleeding. It usually occurs later in pregnancy, and even during or just shortly after labour and delivery.
The symptoms include rapid heart rate, low blood pressure, an irregular heart rhythm and difficulty breathing. If the baby hasn’t been delivered yet, an emergency C-section will need to be performed immediately. After the baby has been delivered, mom will require a blood transfusion.
The risk factors of an amniotic fluid embolism include multiple births, placental abruption, placenta previa, uterine rupture, too much fluid around the baby or labour is induced.
During labour, you are going to be very focused on your breathing. Because of this and the pain you are dealing with, some moms end up hyperventilating. This can cause low levels of carbon monoxide to enter the blood.
If you start to feel dizzy or lightheaded, numbness in your hands or feet or you start to have blurred vision, make sure you let your healthcare provider know. Odds are the nurse or midwife will give you a paper bag to breathe into. Remember to stay calm, breath deeply and after a few inhales and exhales you should start to feel better.
2 Downstairs Pain
Even if you don’t have a tear that requires stitches or an episiotomy (a small incision made in the perineal to give baby more space to be delivered. Sounds scary, but don’t worry, most hospitals no longer do this), odds are right after giving birth you may be feeling some pain in your perineal area.
This is extremely common. Think about it. You’ve just delivered 7 to 8 pounds of baby, it is completely normal to feel some sensitivity and pain in your perineal area. Even if your perineal area is not torn, it will still be stretched, bruised and sore after delivery. You can take some painkillers to help ease the pain and try warm (not hot!) compresses to the area.
1 Lotus Birth
While this isn’t a labour and delivery complication, it is a new procedure—or lack of procedure—that many hospitals and doctors aren’t familiar with. A lotus birth takes the idea of delaying cord clamping one step further and actually suggests that you don’t cut the cord at all and you leave the umbilical cord and the placenta attached to the baby until it dries and falls off on its own.
Those that are for this practice say that it gives the baby a chance to reap all the benefits of the cord blood and placenta. But, there really is no scientific studies on the safety or this practice. And most doctors aren’t convinced that it can help the baby in any way. Once the blood stops flowing through the cord, you’re essentially leaving your baby attached to dead tissue that is, in fact, rotting. We say give this trend a pass, but if you are planning a lotus birth, be sure to speak to your practitioner beforehand.
References: americanpregnancy.org, mayoclinic.org, wikipedia.org, babycentre.co.uk, merckmanuals.com, merckmanuals.com, healthline.com, medlineplus.gov, birthinjuryguide.org, americanpregnancy.org, babycenter.com, americanpregnancy.org, patient.info, babycenter.com, americanpregnancy.org, womensandinfanthealth.ca, merckmanuals.com, whattoexpect.com, propublica.org, dailymail.co.uk, pinterest.co.uk, femalefirst.co.uk, thenet.ng, nuhitz.com, awesomethings.online, pinterest.ca, dailymail.co.uk, dailymail.co.uk, bishopandholland.com, pinterest.ca, dailystar.co.uk, pinterest.ca, dailymail.co.uk, yahoo.com, malaymail.com, socdaily.com, providr.com, twitter.com, earthbounddoulas.com.