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Gyno's POV: 20 Unexpected Things That Can Make Delivery More Difficult

All pregnant women, their husbands, friends, and family members look forward to them having safe deliveries, since bringing someone into the world is a noble task. Therefore, most of them will do anything in their power to ensure that their deliveries are free of any unwanted complications. These women faithfully attend prenatal clinics and follow their doctors' instructions to the letter. They will even adjust their lifestyle and go for foodstuffs that are healthy and safe for pregnancy.

At the monthly clinics, their doctors will monitor BP, urine, and examine their fluids to ensure that they're healthy enough to continue with the pregnancy. Doctors will even request that the woman get an ultrasound done preferably every trimester to monitor the progress of the developing baby and deal with any issues that may arise.

Once the nine months are almost over, the doctor and soon-to-be mom can only hope for the best-case scenario: a quick and safe delivery. Most deliveries take place without a hitch but there are those times when complications arise. During such instances, doctors need to do everything in their power to ensure that mom and baby are safe. The mother should try her best to remain calm and positive when issues arise during delivery.

However, here are 20 unexpected things that can make delivery more difficult than everyone expects.

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20 Malposition

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Malposition is an abnormal position of the baby’s head in the womb that can make delivery difficult. The most common malposition is the posterior position where the baby’s head is down but the baby is facing the mother’s abdomen instead of the back. This can result in longer labor that comes with backaches. In some cases, doctors can turn the babies' positions so the women can give birth normally.

Another malposition is a breech baby where the baby’s head is facing up instead of down. OB-GYN Ellen Giesbrecht told Todays Parent that around 5% of women have breech babies although sometimes if the woman is not yet 36 weeks along, the baby can turn. Depending on their position, a doctor can turn a baby manually using forceps or encourage the mom to deliver through a cesarean section.

19 Preeclampsia

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Preeclampsia is another unexpected pregnancy complication that can make delivery difficult. Preeclampsia is a condition in pregnancy where a mother gets high BP. Its symptoms include swelling of hands and feet and excess protein in the mother’s urine, according to Healthline.

If a mother has preeclampsia, she might get complications like decreased plasma and oxygen flow, premature detachment of the placenta from the uterus, maternal seizures, breathing problems, or a stroke. If the mother has preeclampsia, most healthcare providers will want to deliver the baby as soon as possible especially if the baby is full term.

18 Pain Meds Don't Always Work How They Should

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Labor and delivery are usually painful processes and sometimes women may require meds to help with the pain. The most common type of pain management is an epidural injection, which doctors administer on the woman's lower back. The injection usually blocks the pain of labor contractions, but sometime the epidural may not work.

According to HuffPost, sometimes epidurals do not work because of the woman’s anatomy; her labor can progress quicker than expected or the epidural block may not be ready on time. Such unexpected occurrences can make delivery even more difficult. Doctors can opt for an increase or change in meds or forgo them and result in natural ways of relieving pain.

17 Prolapsed Umbilical Cord

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Umbilical cord prolapse is an unexpected complication that occurs prior to or during delivery of the baby that can make the entire process more difficult. In a prolapse, the umbilical cord drops to the birth canal ahead of the baby. Prolapse presents a danger to the baby because any pressure exerted on the cord can compromise their plasma flow to the baby according to Cleveland Clinic.

In this case, the mother has to have a quick delivery to prevent any permanent complications to the little one. It also means that the mom has to forgo normal birth and go for an emergency cesarean birth. Prolapse can be the result of early labor, multiple pregnancies, having a long umbilical cord and/or excess amniotic fluid.

16 Post Term Baby

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Due dates are normally estimates and it is normal to give birth before or after due dates. According to Mayo Clinic, due dates are simply calculated estimates of when the baby will be 40 weeks and sometimes may be calculated incorrectly. However, when the baby goes beyond 41 weeks the delivery process can become more difficult.

This is because the baby will become significantly larger than average at birth increasing the chances of a caesarian birth, shoulder dystocia, or amniotic fluid decreasing. Late-term pregnancies pose delivery complications like tears down there, postpartum leaking, and infections. In most cases, doctors may give meds to kick-start the labor process.

15 Carrying Multiples Can Be Challenging

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Carrying multiples usually increases the chances of developing pregnancy complications because most will be born preterm. According to A. Pregnancy, the length of gestation typically decreases with each additional baby. Twin pregnancies last 36 weeks while quintuplets last 29 weeks.

A woman carrying multiples needs extra monitoring during her pregnancy. Identical twins who share a placenta also require constant monitoring because they can develop twin-to-twin transfusion syndrome (TTTS) where one twin ends up stealing nutrition for the other. If a mother has twins, she can have a normal delivery; however, the potential for problems during delivery is high and increases with additional babies.

14 Preterm Labor

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Preterm labor is labor that begins before a woman gets to 37 weeks of pregnancy. This happens unexpectedly and can make the delivery process difficult. What makes it worse is that the baby might develop complications if born too early. According to WebMD, the baby can develop complications like not being heavy enough, respiratory distress, and digestive problems.

Although doctors may not know the exact cause of most preterm labor, many things can contribute to it like preeclampsia, infections, chronic illnesses, use of meds, and an abnormal uterus structure as stated by Stanford Children's. Depending on how early preterm labor occurs, most of the time the baby will be born via caesarian because it cannot handle a normal birth.

13 Certain Infections

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If a pregnant woman contracts certain infections, her delivery process may become more difficult. As stated by HealthLine, viral, bacterial, and parasitic infections can complicate a pregnancy. Some diseases and infections can get to the baby during normal birth so it is best for mom to give birth via caesarian.

Other infections like group B streptococcus can allow mom to give birth normally but she has to take some antibiotics during delivery. The goal is always to prevent the little one from catching the infection, which can be hard to fight off because of their low immunity. Nevertheless, moms should take measures to avoid getting any infections while pregnant.

12 Uterine Ruptures

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Moms who have already had C-section births are at a higher risk of getting uterine ruptures. Labor requires a lot of pushing and straining which can put stress on the previous C-section scar causing it to rapture. This especially happens with moms who have chosen to have normal births after previously having a C-section.

Other factors that can cause uterine ruptures include the size of the baby, the mother’s age and the use of instruments during normal births. Uterine rapture makes delivery more difficult. According to Medical News Today, when it occurs it puts the baby at risk of oxygen deprivation and an emergency caesarian is the best way out.

11 Fetal Distress

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While women do not anticipate fetal distress during delivery, it can happen. According to MSD Manuals, fetal distress is a sign during labor that indicates that the fetus is not well. Fetal distress can be caused by any of the following; a nuchal cord, pain meds administered during labor, prolonged labor, rapid labor, infections, or induction of labor.

Doctors usually detect fetal distress when there is an abnormality in the fetus heart rate and this is why doctors have to monitor the baby during labor. When it occurs, doctors have to stop administering all the meds they use to induce labor. Changing the position of the pregnant woman can also help calm the baby. If these do not work, options such as vacuum extraction or caesarian section are on the table.

10 Prolonged Labor

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Prolonged labor is labor that commences but does not progress and this can, of course, lead to a difficult delivery. Prolonged labored for first-time moms occurs when she has been in labor for 20 hours or more and 14 hours or more for a second time mom. Medical News Today states that studies show that around eight percent of pregnant women will have prolonged labor.

Prolonged labor during the first stages of labor is the result of slow effacement of the cervix. It can also occur during the active stage especially when the baby is too big and the birthing canal is small. C-section delivery is usually one of the most common solutions for prolonged labor.

9 A Nuchal Cord

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A nuchal cord is a situation where the umbilical cord wraps itself around the neck of the unborn baby, which is as dangerous as it sounds, especially if the mom never went through ultrasonography for whatever reason. It is impossible to detect this situation beforehand without the use of technology.

According to MSD Manuals, this occurs in close to a quarter of all deliveries, a doctor can simply slip the cord gently over the baby's head during delivery to prevent any harm to the baby. In situations where the cord is too tight, the doctor can clamp and cut it before the shoulders get past the birth canal.

8 Perinatal Asphyxia

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Perinatal asphyxia is a condition that results when a newborn does not receive enough oxygen before, during, or immediately after delivery. Perinatal asphyxia can lead to a difficult delivery and if it is prolonged it can harm the baby’s brain.

According to Birth Injury Guide, treatment for perinatal asphyxia can be through giving the mother more oxygen or performing a caesarian birth. Babies who experience perinatal asphyxia are typically born quiet and doctors have to work fast to get them to breathe. A baby can stop breathing owing to several factors, like when an umbilical cord prolapses or when the baby is born prematurely when his or her lungs are not fully developed.

7 Cephalopelvic Disproportion (CPD)

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Labor and birth can occur in a matter of minutes but sometimes complications may arise that can make it difficult, CPD is one of these complications. Cephalopelvic disproportion occurs when the baby’s head or body is not able to fit through the mother’s pelvis or when the baby is stuck in an unusual position.

This condition is rare and diagnosing it before labor begins is almost impossible because there is no way of telling if the mother’s pelvis is too small to allow the baby to fit through. When a mother has acute CPD, the safest way to deliver the baby is via C-section, as stated by A. Pregnancy.

6 Gestational Diabetes

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Gestational diabetes is a condition in which a woman without diabetes develops high sugar levels during pregnancy. WebMD points out that gestational diabetes occurs when pregnancy hormones cause a buildup of glucose in the veins and the pancreas is unable to produce enough insulin to regulate the sugar levels.

A woman with this condition can have a difficult delivery. If untreated, it can affect the pregnancy and the baby’s health. If a doctor catches gestational diabetes early in pregnancy, the woman can take precautions to control her sugar levels. Doing this can prevent a difficult birth and keep the baby healthy as stated by Mayo Clinic. Gestational diabetes usually goes away after giving birth

5 Shoulder Dystocia

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Another complication that can cause a difficult pregnancy is shoulder dystocia. This occurs during delivery when the baby’s head manages to come out but the shoulders remain trapped inside the mother. Shoulder dystocia is not common but it mostly occurs to first-time mothers.

Pulling the baby out using force can lead to complications. To help maneuver and release the shoulders, doctors can change the mother’s position or manually turn the baby’s shoulders as stated by Medical News Today. In some cases, they will have to perform surgical widening to make more room for the baby. A doctor must intervene with urgency to avoid a lower fetal heart rate.

4 Placenta Previa

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Placenta Previa is a condition where the placenta lies low in the uterus, partially or completely closing the cervix. When a woman has with Placenta Previa, a doctor prescribes supervised bed rest in the hospital or at home. She will need to go for frequent checkups but eventually, a caesarian delivery will be the best way out.

As stated by Medical News Today, Placenta Previa may sometimes cause uncontrolled bleeding or cause a non-assuring fetal heart rate. When this occurs, an emergency C-section is the best option. Placenta Previa also increases the risk of a life-threatening condition known as Placenta accreta, where the placenta becomes inseparable from the uterus wall.

3 Amniotic Fluid Embolism (AFE)

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The amniotic fluid embolism occurs when the amniotic fluid in the uterus enters the mother's stream, usually during difficult labor or when a woman is undergoing a C-section. According to WebMD, although rare, an amniotic fluid embolism is one of the most serious delivery complications, it is actually life-threatening.

AFE symptoms include shortness of breath, fetal distress, seizures, sudden low BP, skin discoloration, cardiovascular collapse and loss of consciousness. AFE can occur in both normal and cesarean births and doctors are yet to find a way to prevent it. However, managing its symptoms is what doctors do. The baby cannot also be born until the condition becomes stable.

2 Meconium Aspiration

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Meconium is a black, tarry substance produced in the intestines of a fetus before birth. Ideally, the baby is supposed to pass it out after birth but in some cases when the baby gets distressed during labor, he can pass the meconium in the amniotic fluid and the mom has to go for an emergency C-section.

Meconium Aspiration is the process where the baby inhales the meconium while in the womb. According to Parents, meconium aspiration usually occurs in overdue babies. It can cause significant health complications. Once the baby is born and doctors notice that the baby has inhaled its meconium, they normally clean the baby’s nose and mouth and place him or her in the intensive care unit.

1 The Doctor Being Unavailable

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Medical conditions are not the only situations that can make delivery difficult. Sometimes even external factors like the mother’s doctor being unavailable during the delivery can make things difficult. Unfortunately, a woman cannot foresee her doctor being unavailable when she goes into labor.

When this occurs, the doctor who is on call has to attend to the mother on the day of delivery. Changing a doctor last minute can be stressful especially if the new doctor’s opinion differs from that of the woman’s regular doctor. As stated by BabyCenter, doctors can be different, some can approve of normal births after C-sections while others will not. The difference in opinions can change the entire birth plan and cause the mother anxiety, which can lead to a difficult delivery.

Sources: parents.com, babycenter.com, todaysparent.com, healthline.com, huffpost.com, clevelandclinic.org, mayoclinic.org, a. pregnancy.org, stanfordchildrens.org, webmd.com, medicalnewstoday.com, msdmanuals.com, sharecare.com, birthinjuryguide.com

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