The most common complication of childbirth is labor that does not progress
During labor, a surge of hormones called oxytocin causes the muscles in the mother’s uterus to contract to allow her cervix to dilate and male room for the baby to pass through. Delivery can occur in two ways: vaginal (through the birth canal) or cesarean (surgical).
With the advent of modern medicine, most complications of childbirth can be anticipated and managed in time. However, a few complications may occur unexpectedly, and some may be life-threatening to both mother and child.
Labor that does not progress
By far, the most common complication during childbirth is labor that does not progress. Sometimes, labor starts fine but over time the contractions slow down, the cervix doesn’t dilate enough, and the baby’s descent in the birth canal is hindered.
Who is at risk?
This complications occur in the following conditions:
- First-time pregnancies
- Women over 35
- Baby weighs more than 8.82 pounds in utero
- Baby is in an abnormal position in the utus (breech position)
- Mother has weak uterine contractions due to exhaustion and dehydration or in cases of prolonged labor
If your labor is nonprogressive, your doctor may put you on a Pitocin drip, or synthetic oxytocin, to increase contractions and speed up labor. If that fails, you may need to be taken for a cesarean delivery.
What are other complications of childbirth?
Other common childbirth complications include:
- Premature rupture of the membranes: Labor proceeds within 24 hours of a woman's water breaking. If your water breaks before 34 weeks of pregnancy, this is known as early rupture of the membranes and can cause infection to the baby or further complications.
- Perineal tears: Your vagina and the surrounding tissues are likely to tear during delivery. Usually they heal fine, but in some cases, the tears are deeper and may need stitches. This can cause your pelvic muscles to weaken, causing future problems such as urinary incontinence.
- Eclampsia: A sudden increase in blood pressure during labor can cause seizures in the mother. This condition is more common if you have had an increase in blood pressure at any time during your pregnancy.
- Excessive bleeding: If delivery results in tears to the uterus or if the uterus does not contract to deliver the placenta, it can result in heavy bleeding. This is called postpartum hemorrhage and is a leading cause of maternal deaths in many countries.
- Preterm labor: Preterm labor means the mother goes into labor before week 37 of pregnancy, before the baby’s organs have matured. A preterm labor needs special interventions for the baby, such as the neonatal intensive care unit (NICU).
- Postpartum sepsis: Infection of the uterus after delivery is common in people with compromised immunity, such as those with human immunodeficiency virus (HIV), diabetes, etc. The condition presents with foul-smelling vaginal discharge and high fever, and the mother may end up with sepsis.
What complications can occur with the baby?
The following complications can arise in the baby:
- Umbilical cord around the neck: The umbilical cord may get caught on an arm or leg or wrap around the neck as the infant moves through the birth canal.
- Abnormal heart rate: An abnormal heart rate in the baby during labor is not always an issue if it is temporary. If the heart rate remains low for a longer time, the baby may suffer, requiring emergency cesarean delivery.
- Shoulder dystocia: This is typically seen in big babies, if the mother has diabetes, or if the infant's head has come out of the vagina but one of their shoulders becomes stuck. In such cases, the mother will need a lower segment cesarean section (LSCS).
What are complications of cesarean delivery?
In a cesarean delivery (C-section), the baby is surgically removed through an incision in the mother's abdomen and then a second incision in the uterus. Rates of cesarean deliveries have increased exponentially and been linked with different factors, from increasing rates of obesity and diabetes to multiple births and increased maternal age.
Once delivery and afterbirth are complete, doctors repair the incisions made to the mother's uterus with stitches, which will eventually dissolve under the skin. They close the abdominal skin with stitches or staples, which will be removed before the mother leaves the hospital.
Complications of cesarean delivery include:
- Infection (After a C-section, the mother might be at risk of endometritis, which is an infection of the lining of the uterus)
- Postpartum hemorrhage (constant bleeding from the uterus)
- Reactions to anesthesia
- Blood clots
- Wound infection
- Surgical injury
- Increased risks during future pregnancies