Each pregnancy and delivery is different, and problems may arise.
If complications occur, providers may assist by monitoring the situation closely and intervening, as necessary.
- Labor that does not progress. Sometimes contractions weaken, the cervix does not dilate enough or in a timely manner, or the infant's descent in the birth canal does not proceed smoothly. If labor is not progressing, a health care provider may give the woman medications to increase contractions and speed up labor, or the woman may need a cesarean delivery.3
- Perineal tears. A woman's vagina and the surrounding tissues are likely to tear during the delivery process. Sometimes these tears heal on their own. If a tear is more serious or the woman has had an episiotomy (a surgical cut between the vagina and anus), her provider will help repair the tear using stitches.4,5
- Problems with the umbilical cord. The umbilical cord may get caught on an arm or leg as the infant travels through the birth canal. Typically, a provider intervenes if the cord becomes wrapped around the infant's neck, is compressed, or comes out before the infant.5
- Abnormal heart rate of the baby. Many times, an abnormal heart rate during labor does not mean that there is a problem. A health care provider will likely ask the woman to switch positions to help the infant get more blood flow. In certain instances, such as when test results show a larger problem, delivery might have to happen right away. In this situation, the woman is more likely to need an emergency cesarean delivery, or the health care provider may need to do an episiotomy to widen the vaginal opening for delivery.6
- Water breaking early. Labor usually starts on its own within 24 hours of the woman's water breaking. If not, and if the pregnancy is at or near term, the provider will likely induce labor. If a pregnant woman's water breaks before 34 weeks of pregnancy, the woman will be monitored in the hospital. Infection can become a major concern if the woman's water breaks early and labor does not begin on its own.7,8
- Perinatal asphyxia. This condition occurs when the fetus does not get enough oxygen in the uterus or the infant does not get enough oxygen during labor or delivery or just after birth.3,4
- Shoulder dystocia. In this situation, the infant's head has come out of the vagina, but one of the shoulders becomes stuck.5
- Excessive bleeding. If delivery results in tears to the uterus, or if the uterus does not contract to deliver the placenta, heavy bleeding can result. Worldwide, such bleeding is a leading cause of maternal death.9 NICHD has supported studies to investigate the use of misoprostol to reduce bleeding, especially in resource-poor settings.
Delivery may also require a provider's special attention when the pregnancy lasts more than 42 weeks, when the woman had a C-section in a previous pregnancy, or when she is older than a certain age.
- Elixhauser, A., & Wier, L.M. (2011). Complicating conditions of pregnancy and childbirth, 2008. HCUP Statistical Brief #113. Rockville, MD: Agency for Healthcare Research and Quality. Retrieved February 23, 2017, from http://www.hcup-us.ahrq.gov/reports/statbriefs/sb113.pdf (PDF – 292 KB)
- Stranges, E., Wier, L. M., & Elixhauser, A. (2012). Complicating conditions of vaginal deliveries and cesarean sections, 2009. HCUP Statistical Brief #131. Rockville, MD: Agency for Healthcare Research and Quality. Retrieved February 23, 2017, from http://www.hcup-us.ahrq.gov/reports/statbriefs/sb131.pdf (PDF – 291 KB)
- Shields, S. G., Ratcliffe, S. D., Fontaine, P., & Leeman, L. (2007). Dystocia in nulliparous women. American Family Physician, 75(11), 1671–1678. Retrieved February 23, 2017, from http://www.aafp.org/afp/2007/0601/p1671.html
- American College of Obstetricians and Gynecologists. (2016). Ob-gyns can prevent and manage obstetric lacerations during vaginal delivery, says new ACOG Practice Bulletin. Retrieved February 16, 2017, from http://www.acog.org/About-ACOG/News-Room/Ne="ws-Releases/2016/Ob-Gyns-Can-Prevent-and-Manage-Obstetric-Lacerations
- World Health Organization. (2007). Managing complications in pregnancy and childbirth: A guide for midwives and doctors. Retrieved February 16, 2017, from http://apps.who.int/iris/bitstream/10665/43972/1/9241545879_eng.pdf (PDF – 5.47 MB)
- MedlinePlus.(2016). Episiotomy. Retrieved April 17, 2017, from https://medlineplus.gov/ency/patientinstructions/000482.htm
- MedlinePlus.(2016). Premature rupture of membranes. Retrieved February 16, 2017, from https://medlineplus.gov/ency/patientinstructions/000512.htm
- American College of Obstetricians and Gynecologists. (2008). ACOG guidelines on premature rupture of membranes. American Family Physician, 77(2), 245–246. Retrieved February 23, 2017, from http://www.aafp.org/afp/2008/0115/p245a.html
- American College of Obstetricians and Gynecologists. (2006; reaffirmed 2015). ACOG Practice Bulletin: Clinical management guidelines for obstetrician-gynecologists number 76, October 2006: Postpartum hemorrhage. Obstetrics & Gynecology, 108(4), 1039–1047. Retrieved August 7, 2017, from https://www.ncbi.nlm.nih.gov/pubmed/17012482