Labor complications
slow progress of labor
When the child is in an unusual position
multiple pregnancy
concern about the child's condition
postpartum hemorrhage
retained placenta
Even if you are healthy and well prepared for labor and delivery, there is always the chance of unexpected difficulties occurring.
slow progress of labor
Your doctor or midwife can tell how far your labor is progressing by checking how well your cervix is opening and how far your baby has descended. If your cervix is opening slowly, or your contractions slow down or stop, your doctor or midwife may say your labor isn't progressing. It's good to be able to relax and calm down—anxiety can slow things down even further. Ask what you and your support person can do to help things along.
Your midwife or doctor may suggest some of the following:
- Change to a position you feel comfortable in.
- Walking - Movement can help the baby move down further, and encourage contractions.
- warm shower or bath
- back rub
- Take a nap to recharge.
- You have something to eat or drink.
If progress continues to be slow, your midwife or doctor may suggest inserting an intravenous drip with Syntocinon to make contractions more effective. If you're tired or uncomfortable, you may want to ask about pain relief options.
When the child is in an unusual position
Most babies are born breech, but some are in positions that may complicate labor and delivery.
Back position
This means the baby's head enters the pelvis toward your front instead of your back. This can mean longer labor with more back pain. Most babies turn during labor, but some don't. If the baby doesn't turn, you may be able to push it out yourself, or your doctor may need to turn the baby's head and/or assist it with either forceps or a vacuum pump. You can help by getting on your hands and knees and rotating or rocking your pelvis—this may also help relieve back pain.
Birth buttocks
This occurs when the baby presents with their buttocks or feet first. In Australia, about 3-4% of babies are in the breech position when labor begins. Sometimes a procedure called "external cephalic version" is discussed—this is where the doctor gently turns the baby late in pregnancy by placing their hands on your belly and gently coaxing the baby so that they are born head first. This rotation is performed at around 36 weeks, using an ultrasound to help view the baby, cord, and placenta.
Both the baby and mother are monitored during the procedure to ensure everything is fine. There is a small risk that the baby's heartbeat could cause the umbilical cord to become entangled or the placenta to separate from the uterus. This is why the procedure is performed in a hospital, in case an emergency cesarean section is needed.
Your midwife or doctor will discuss with you the best way to manage breech labor and delivery. If the baby is still in a breech position at the end of pregnancy, a cesarean section may be recommended.
multiple pregnancy
When there is more than one baby, labor may be premature. When the last baby is born, the placenta (or placentas) is expelled in the usual way. If the babies are premature, they will likely need extra care at birth and for a few days or weeks afterward.
At term, you may be induced if your babies are in the correct position. Your obstetrician often suggests you have an epidural. This is because after the birth of the first twin, the second twin may get into an unusual position, and your obstetrician may need to maneuver the second twin into the birthing position.
Read more about multiple births on the blog here: Women's World.
concern about the child's condition
Sometimes there may be concerns that the baby is experiencing distress during labor. Signs include:
A faster, slower, or unusual pattern of the baby's heartbeat
A bowel movement by the baby (seen as a greenish-black fluid called "meconium" in the amniotic fluid).
If the baby is not coping well, their heart rate will usually be monitored. If necessary, the baby will be delivered as quickly as possible by vacuum delivery or forceps (or possibly by cesarean section).
postpartum hemorrhage
Postpartum hemorrhage is a complication that can occur after childbirth. Postpartum hemorrhage is uncommon. Some blood loss during childbirth is considered normal. Postpartum hemorrhage is excessive vaginal bleeding after childbirth.
To help prevent postpartum hemorrhage, you will be given a Syntocinon injection during your baby's birth, which stimulates contractions and helps push the placenta out.
Your midwife will regularly check your uterus after delivery to ensure it is contracting. Postpartum hemorrhage can cause a number of complications and may mean a longer hospital stay.
Learn more about postpartum hemorrhage here .
retained placenta
Occasionally, the placenta doesn't come out after the baby is born, so the doctor needs to remove it immediately. This is usually done using an epidural or general anesthesia in the theater.
Learn more about retained placenta here .