Many women who are pregnant for the first time often assume that labor and delivery will go smoothly. While it often does, many women face unforeseen complications during labor that may cause injury or, in extreme cases, death.
About 80% of maternal deaths occur in the weeks and months following childbirth, but many women will face difficulties and suffer injuries while giving birth.
1. Prolonged Labor
Prolonged labor occurs when labor takes longer than expected, and this is sometimes referred to as “failure to progress.” Studies suggest that this complication affects about 8% of women giving birth.
According to the American Pregnancy Association, prolonged labor occurs when labor takes longer than 20 hours if it is a first delivery, and 14 hours if the woman has previously given birth.
If prolonged labor occurs during the active phase, medical intervention may be necessary.
This complication may be caused by:
- A large baby
- Slow cervical dilations
- Small birth canal or pelvis
- Slow effacement
- Delivery of multiple babies
- Emotional factors, such as fear or stress
In later stages of labor, doctors may give labor-inducing medications or even recommend a cesarean delivery.
2. Perinatal Asphyxia
Perinatal asphyxia occurs when there is failure to “initiate and sustain breathing at birth.” This can happen before, during or right after delivery. It is caused by an inadequate supply of oxygen.
The condition can lead to:
- High carbon dioxide levels
- Hypoxemia, or low oxygen levels
Organ malfunction and cardiovascular issues can result.
Treatment may include giving oxygen to the mother, or to carry out a cesarean delivery. After giving birth, medication or mechanical breathing may be necessary.
3. Fetal Distress
Fetal distress occurs when a fetus is not doing well. A doctor may describe this complication as “non-reassuring fetal status.”
This condition can be linked to:
- Issues with muscle movement and tone
- Irregular heartbeat
- Low levels of amniotic fluid
There are several ways to overcome episodes of non-reassuring fetal status, including:
- Increasing maternal hydration
- Maintaining the mother’s oxygen levels
- Changing the mother’s position
- Intravenous hypertonic dextrose
4. Shoulder Dystocia
Shoulder dystocia occurs when the head is delivered vaginally, but the shoulders remain in the birth canal.
While uncommon, this complication is more likely to affect women who have never given birth. Shoulder dystocia is responsible for half of all cesarean deliveries in this category.
Doctors can perform specific maneuvers to release the shoulders, such as manually turning the baby’s shoulders or changing the mother’s position. In some cases, a surgical widening of the vagina may be needed to make room for the baby’s shoulders.
5. Placenta Previa
Placenta previa occurs when the placenta covers the cervix. When this occurs, a cesarean delivery is typically required.
This complication affects 1 in 200 pregnancies in the third trimester.
The primary symptom is bleeding without pain during the third trimester. The bleeding can range from light to heavy.
Treatment typically entails having the mother go on bed rest, a blood transfusion and/or immediate cesarean delivery. In some cases, the mother will need to be supervised in the hospital.