When birth goes wrong
Most births are problem free, but being aware of some complications means you are more prepared.
(Getty Images)
Usually, labour and delivery happen without any problems. Serious problems are relatively rare, and most can be anticipated before the birth and treated effectively either by medical intervention or by a caesarean delivery.

Regular visits to your doctor as you approach the big day makes it more likely that a problem can be planned for. If problems happen during the birth you have to rest assure that you are in the hands of medical professionals who will do their best to improve the chances of having a healthy baby and safe delivery.

Some new parents prefer not to know all the things that could go wrong, but if you want to know a bit more, read on. You know yourself and are in tune with yourpregnant body and the routine of your unborn baby’s awake and active times. You might be able to see or feel the signs of any complications before the doctor does.

Separation of the pubic bone
Separation of the pubic symphasis is a recognized complication of pregnancy but it can also occur during labour. Trauma or obstetric interventions such as application of force to move the thighs or the use of forceps may cause this problem. It can be painful, and cause difficulties with walking directly after the labour. Your gynae may become aware of this problem before you go into labour, or it may suddenly arise during the birth.

Excessive bleeding
About 4 percent of women have postpartum hemorrhage, which is excessive bleeding following the birth of a baby.
  • Hemorrhage may occur before or after the placenta is delivered.
  • The average amount of blood loss after the birth of a single baby in vaginal delivery is about 500.
  • The average amount of blood loss for a cesarean birth is approximately 1 litre.
  • Most postpartum hemorrhage occurs right after delivery, but it can occur later as well.

Stuck shoulder
Shoulder dystocia occurs when, after delivery of the head, the baby's shoulder gets stuck behind the mother's pubic bone. If this happens, the remainder of the baby does not follow the head easily out of the vagina as it usually does during vaginal deliveries.
The doctor may use forceps or suction to turn the baby so that it can be brought out more easily. IN rare cases an emergency caesarean might be needed.

Inhaled meconium
Meconium is a thick, sticky, greenish-black substance made of amniotic fluid, mucous, lanugo (the fine hair that covers the baby's body), bile, and cells that have been shed from the skin and the intestinal tract. This usually passes through the baby’s gut and is the first thing you see in the nappies.
  • In some cases, the baby passes meconium while still inside the uterus, especially if it is under stress. This might be, for example, because of a difficult birth.
  • Once the meconium is passed into the amniotic fluid, it is possible for the baby to breathe the meconium into his lungs.
  • This condition is called meconium aspiration and can cause inflammation in the baby's lungs after he or she is born.
If the baby has trouble breathing, he or she might be given oxygen, and possibly treated with antibiotics to clear infection.

Breech birth
If your baby is lying across the cervix, it will be trickier to give birth through the vagina. Some breech babies do turn during early labour, and most midwives and doctors know a trick or two to encourage this. Although breech babies can be delivered vaginally, it's generally safer and easier to deliver babies head first from the vagina. So your doctors may recommend that you deliver a breech baby by c-section.

Strep infection
About 25% of women are carriers of a type of bacteria called Group B Strep (GBS) but show no symptoms. During a natural vaginal delivery your baby will pass through your vagina and come into contact with the bacteria and could get infected.
To prevent this from happening women who test positive for GBS or who have had a previous baby with Group B Strep will be given antibiotics during labour.
Early infections usually occur within a week after birth and infection can cause inflammation of your baby’s lungs, spinal cord or brain.

Upside-down uterus

Very rarely, the uterus is turned inside out during birth, so that it protrudes through the cervix, into or through the vagina. An inverted uterus is a medical emergency that must be treated promptly. Usually the mother recovers fully after the uterus is returned to its correct place.

Tear in the uterus
Sudden severe abdominal pain in later pregnancy should be reported to your doctor, especially if you are at increased risk for rupture of the uterus.
Women with risk factors such as prior c-sections, deep fibroid excisions, and other major uterine surgeries will usually be scheduled for a c-section between 36 and 39 weeks' of pregnancy to prevent this.

Prolapsed umbilical cord
A prolapsed umbilical cord is common in breech deliveries. This happens when part of the umbilical cord slips down through the cervix before the baby does. The cord is then compressed during contractions, which cuts down on blood flow to the baby. An emergency c-section is usually needed.

Cord around neck
The umbilical cord is wrapped around the baby’s neck in about one quarter of deliveries. Normally, the baby is not harmed. Doctors routinely check for it as they deliver the baby. If they feel it, they can slip the cord over the baby's head.

Fetal distress
Fetal distress is a fairly rare complication of labour if the baby doesn’t get enough oxygen. It’s usually picked up because of an abnormal pattern to the baby’s heart rate. Your doctor will move your position, and perhaps give you oxygen to increase the amount the baby is getting. If necessary and emergency caesarean will be performed.

Breathing problems
In rare cases a baby does not start to breathe at birth, even though no problems were detected before delivery. The baby will be resuscitated immediately and will usually be fine after that.

Premature rupture of the membranes (PROM)
In about 10% of normal pregnancies, the fluid-filled membranes containing the foetus rupture before labour begins. Rupture of the membranes is commonly described as "the water breaks." Contractions usually begin within 12 to 48 hours, but may be induced if there is an infection risl.

Late arrival
In most pregnancies that go a little beyond 41 to 42 weeks, no problems develop.
However, problems may develop if the placenta cannot continue to maintain a healthy environment for the fetus. This condition is called postmaturity.Typically, at 42 weeks, labour is induced, or the baby is delivered by c-section.

Slow labour
If labor is progressing too slowly, the fetus may be too big to move through the birth canal (pelvis and vagina). Delivery by forceps, a vacuum extractor, or c-section may be necessary.

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