Pregnancy is the most wonderful part of a woman’s life. It is the time when the transition into motherhood introduces you to a whole new world of emotions that you never knew you could feel. In the nine months of your pregnancy, you begin to form a bond with your unborn child; you feel a powerful connection and the fierce need to protect your baby from every possible threat.
Though most pregnancies get by smoothly, one should be prepared for the worst of all situations – delivery complications. It does require nerves of steel to even imagine something untoward happening with your baby, but talking and discussing all possible situations and solutions with your doctor will help put you in the correct frame of mind.
Some of the most common childbirth complications that take place in the delivery room are listed below.
In layman terms, this signifies that the fetus is suffering in some way and needs to be operated upon urgently. Fetal distress can happen due to a number of reasons – umbilical cord loop around baby’s neck, medications used to cause labor, vaginal infections to name a few. Fetal monitoring is, therefore, used by most hospitals and maternity clinics today during delivery, to keep track of the baby’s movement in the womb, its first bowel movement, changes in its heart rate etc. If any of these indicators show the baby is in distress, a cesarean section may need to be performed, or the use of forceps or vacuum extractor may be called for to hasten the birthing process.
Obstructed labor or dystocia, is a delivery complication that may occur due a number of factors, including incoordinated uterine activity, abnormal fetal presentation, absolute or relative cephalopelvic disproportion, or, in rare cases, a massive fetal tumor. Shoulder dystocia occurs when the anterior shoulder of the infant cannot pass below the pubic symphysis or requires external manipulation to pass below it. Forceful pulling may result in deforming the baby’s shoulder. Causes of this condition have been known to include prolonged interval between pregnancies, primigravid birth, and multiple births. In the worst of cases, the results could fetal death, respiratory depression, hypoxic ischaemic encephalopathy (HIE), and brachial nerve damage.
Hemorrhage or abnormal loss of blood refers to loss of more than 500 ml of blood after delivery, in the mother. This is the most common childbirth complication and occurs in 18 percent of births, and has the highest rate of maternal morbidity in developed countries. Risk factors for postpartum hemorrhage include a prolonged third stage of labor, multiple deliveries, episiotomy, fetal macrosomia, and a history of postpartum hemorrhage. The best preventive strategy used by doctors worldwide is active management of the third stage of labor. It involves administering a uterotonic drug with or soon after the delivery of the anterior shoulder, controlled cord traction, and early cord clamping and cutting.
A uterine rupture refers to a tear in the wall of the uterus and occurs most often at the site of a previous c-section incision. A complete rupture happens when the tear goes through all layers of the uterine wall which may result in dire consequences for mother and baby. Early signs of a rupture include an abnormality in the baby’s heart rate, while the mother may have symptoms such as abdominal pain, vaginal bleeding, a rapid pulse, and other signs of shock. In some cases, pain in her chest has also been reported caused due to irritation to the diaphragm from internal bleeding. Labor, too, may slow or stop.
Labor – the name itself sets the theme for what is to come. For some it is a dream, and for some, a nightmare. Prolonged labor refers to labor stalls or extremely slow labor. It is also referred to as ‘failure to progress’. If you haven’t given birth after approximately 20 hours of regular contractions, you are likely to be in prolonged labor. Some health experts may say it occurs after 18 to 24 hours. In case of twins, prolonged labor refers to labor that lasts more than 16 hours. It usually occurs when the baby is too big to travel through the birth canal, or it is in breech, i.e. legs-first position, or the birth canal is too small for the baby to move, or your contractions are weak. Usually a C-section is performed to ease the process.
Any deviation from the normal position of the fetus for delivery is referred to as abnormal presentation. This delivery complication may occur if the fetus has too much room to move in the womb, mainly due to its less than average size, or due to excess amniotic fluid around it. Multiple births also may be a cause for an abnormal presentation. The fetal position can usually be detected in the last sonogram, as well as during labor. The doctor then decides whether to operate and do a C-section to ensure the safety of the baby.
It is good to be informed about the kinds of birthing complications that may occur, but try not to dwell on them. Stay positive throughout pregnancy and take the best possible care of yourself.