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Though many women have safe and uncomplicated labor experiences, giving birth to healthy babies, birth complications exist, which risk maternal or fetal health. It makes sense to understand what may potentially go wrong since pregnancy is not without risks. There are different ways to classify birth complications and one method is to discuss complications occurring as a result of a condition prior to labor, and those that develop during labor. There are many complications and examples below only make up a portion of these.
Birth complications existing prior to labor may increase labor risks. One of these is a previous c-section. Some women have had a c-section and want to deliver vaginally the next time, which is called a vaginal birth after c-section (VBAC). When this is attempted it may or may not work and some women trying for a VBAC end up requiring surgical delivery. To lessen the possible birth complications arising during a VBAC, doctors and patients often decide in advance when surgery might be performed if labor is not proceeding at a regular pace.
Another pre-existing condition that might severely complicate labor is severe illness in the mother. Illnesses such as pre-eclampsia or gestational diabetes might pose a real risk to mother and child. Sometimes vaginal birth is not attempted when these illnesses are present because the risk is too high. Similarly, severe traumatic injury to a mother may cause pre-term birth or necessitate c-section.
Multiple births are, by nature, complicated. They can go perfectly or pose risk. Some women deliver twins vaginally, but higher order multiples may need additional support and often are born pre-term.
Birth complications may develop during labor or be obviously present just a week or two before labor begins. One common one is the way the baby presents. Normally, babies are born head first, but some might be breech with feet or rear end pointing toward the birth canal. This is challenging because the baby’s body may be fairly easily delivered, but the head can get stuck, since it is larger. Breech presentation may require an attempt to turn the baby, which can be difficult and painful, or determining if a c-section is more appropriate.
Even in the appropriate position the head may get stuck, particularly if it is very large, and require the use of forceps or vacuum extraction. A very large head might require c-section. Birth complications like shoulder dystocia might occur too, where a shoulder cannot pass through after the head. Manipulating the fetal arm to allow passage may cause damage to the shoulder.
Sometimes labor fails to progress, requiring intervention, or birth complications like precipitous labor might occur, with overly fast labor. Prolapse or early delivery of the umbilical cord creates exceptional risk for the baby cutting off oxygen supply and more risk exists if the cord is wrapped around the baby’s neck, and in some parts of the world, infection remains a great risk after labor, mostly due to poor sanitation.
I have a friend who nearly lost her first baby and did lose her second baby because of pre-eclampsia. Her blood pressure went sky-high. Her daughter was born weighing 1 pound, 10 ounces, but she made it and is now eight years old. Her son was stillborn. She had a third child, just a little early, and he's fine too, but she still had to keep a close eye on her blood pressure the whole time.
She's now a nurse in a neonatal intensive care unit, taking care of babies who suffered birth complications. She said her experiences help her with the little ones, and with their families.
One of my co-workers had to have an unexpected C-section. Her birth plan was to have a vaginal delivery, but her labor just didn't progress normally. She started off fine, but then hit a plateau where she wasn't dilating and the baby wasn't moving through the birth canal. Everything had just stopped, except for the labor pains. Only they weren't doing much good.
Her OB gave her several hours and even gave her medications designed to speed delivery, but the baby was going into fetal distress, so they had to do an emergency C-section. It just goes to show you complications can pop up very unexpectedly.
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