You’ve made it through pregnancy, and it’s time to bring a new life into the world. Nobody likes to think things will go wrong, but it can be a tricky process. Here are some of the most common birth complications.
1Failure to progress
Sometimes women can experience prolonged labour or one that ‘fails to progress’. This is defined by the American Pregnancy Association as labour that lasts longer than 20 hours for a first baby, or more than 14 hours in a subsequent delivery.
This affects around 8% of births and is caused by various factors. These include slow cervical dilation, a large baby, a small pelvis or multiple babies. Stress and fear can also cause failure to progress. Certain types of pain relief medication slow or weaken contractions.
In the early stage of labour, while tiring for the mother, this doesn’t usually cause any problems. If it happens during the ‘active’ phase of birth, however, intervention may be needed – in some cases, a C-section delivery.
Sometimes the opposite happens, and labour progresses rapidly, lasting only three to five hours. (Typically, from start to finish, labour will take 6-18 hours.)
Precipitous labour, as it’s known, is more likely to happen if there is a history of it in a family or if the baby is small. It could also be due to the uterus contracting particularly efficiently and strongly.
The mother might feel exhausted as labour can feel like one continuous contraction. She might feel as though she’s not in control. It might also mean there’s not enough time to get to hospital or receive some methods of pain relief, such as an epidural.
Rapid delivery carries a greater risk of tearing and damage to the mother’s cervix and vagina. She’s more likely to haemorrhage and go into shock. There’s a risk of infection to the newborn if delivery happens in an unsterile location.
3Problems with position
The ‘usual’ position for babies during normal vaginal delivery is head first and facing downwards. Most settle into this ahead of labour – but not always.
Some babies face upwards, while others are breech – either bottom or feet first. In some cases, they lie horizontally across the uterus.
Sometimes it’s possible to manually manipulate the baby into a different position. Other solutions include using forceps or performing an episiotomy during delivery. A C-section may be necessary in some cases.
4Problems with the umbilical cord
The umbilical cord sometimes becomes wrapped around the baby. This happens more frequently than many people think, simply because it’s not always an issue.
Marjorie Greenfield, obstetrics and gynaecology professor at Case Western Reserve University School of Medicine in Cleveland, Ohio, US, explains: “Often the cord is wrapped around the baby’s body or arm, and the doctor doesn’t even mention it because it didn’t cause any problems.”
However, if the cord is around the baby’s neck, is compressed – decreasing blood-flow – or emerges before the baby, medical intervention will be necessary.
The most common cause is when the scar from a previous C-section delivery opens during labour. There’s also a higher risk if labour has been induced, in older mothers (aged 35 or more), if the baby is large or if instruments such as forceps are used.
Signs the uterus has ruptured include an abnormal foetal heart rate and, for the mother, a rapid heart rate and low blood pressure. She may experience abdominal pain, tenderness around a previous scar, a slowing of progress in labour and excessive bleeding.
If the uterus ruptures, there is a risk the baby will be deprived of oxygen. Blood loss from the mother can also be an issue. Any woman planning a vaginal birth after a previous C-section delivery should discuss the problems with her medical consultant.