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Although serious complications are rare during labor, some problems can develop during this time. Some of the more common complications include:
When the amniotic sac ruptures, the normal color of the amniotic fluid is clear. However, if the amniotic fluid is greenish or brown in color, it may show fetal meconium, which is normally passed after birth as the baby's first bowel movement. Meconium in the amniotic fluid may be associated with fetal distress. A woman should talk with her healthcare provider immediately.
The fetal heart rate during labor is a good sign of how the fetus is handling the contractions of labor. The heart rate is usually electronically monitored during labor. The normal range varies between 120 and 160 beats per minute. If a fetus appears to be in distress, immediate action can be taken. The mother can be given oxygen, increase fluids, and change her position.
The normal position for the fetus during birth is head-down, facing the mother's back. However, sometimes a fetus is not in the right position, making delivery more difficult through the birth canal. There are several abnormal positions for a fetus, including the following:
Positioned head-down but facing the mother's front
Positioned with the face down into the mother's pelvis, instead of the top of the fetal head
Positioned with the brow down in the mother's pelvis
Positioned breech (where the buttocks or feet are down first in the mother's pelvis)
Positioned with 1 shoulder in the mother's pelvis
Depending on the position, a healthcare provider may try to deliver the fetus as it presents itself, attempt to turn the fetus before delivery, or perform a cesarean delivery.
Delivery is the moment when the fetus, followed by the placenta, exits the mother's body. In preparation for the delivery, a woman may be moved into a birthing room or delivery room. Or she may remain in the same room for both labor and delivery. Fathers or partners are encouraged to be actively involved in the process of childbirth by helping with relaxation methods and breathing exercises.
Positions for delivery may vary from squatting, sitting, to semi-sitting positions (between lying down and sitting up). With semi-sitting positions, gravity can help the mother push the baby through the birth canal. The type of position for delivery depends on the preference of both the mother and the healthcare provider, as well as the health of the fetus.
During the delivery process, the medical personnel will continue to keep an eye on the mother's vital signs, like blood pressure and pulse, and the fetal heart rate. The healthcare provider will examine the cervical opening to determine the position of the fetus' head and will continue to support and guide the mother in her pushing efforts.
Delivery can be done either vaginally or by cesarean section (C-section).
During a vaginal delivery, the healthcare provider will assist the fetus' head and chin out of the vagina when it becomes visible. Once the head is delivered, the healthcare provider applies gentle downward traction on the head to deliver the shoulder, followed by the rest of the body. The baby turns itself as the last movement of labor.
In some cases, the vaginal opening does not stretch enough to accommodate the fetus. It may be necessary to speed up delivery, for example, if the baby is in distress. In such cases, the healthcare provider may perform an episiotomy. This is a cut through the vaginal wall and the perineum. This are is between the thighs, extending from the anus to the vaginal opening. An episiotomy is done to help deliver the fetus. Episiotomies are not needed for every delivery and are not routinely performed.
After the delivery of the baby, the mother is asked to continue to push during the next few uterine contractions to deliver the placenta. Once the placenta is delivered, any tear or episiotomy is repaired. The mother is usually given oxytocin. This is a drug given either by an injection into the muscles or intravenously that is used to contract the uterus. The uterus is then massaged to help it contract, and to help prevent excessive bleeding from happening.
If a woman is unable to deliver the fetus vaginally, the fetus is delivered surgically, by performing a cesarean section. Cesarean sections are usually performed in an operating room or a designated delivery room. Some cesarean sections are planned and scheduled, while others may be performed as a result of complications that occur during labor.
Once the anesthesia has taken effect, a cut is made in the stomach, and an opening is made in the uterus. The amniotic sac is opened, and the baby is delivered through the opening. The woman may feel some pressure and/or a pulling sensation.
Following the delivery of the baby, the healthcare provider will stitch the uterine and the cut that was made in the stomach. After a cesarean or vaginal delivery, women will have some bleeding.
There are several conditions that may make having a baby by cesarean section more likely. These include:
Previous cesarean section
Abnormal delivery presentation, like breech, shoulder, or face
A labor that fails to progress or does not progress normally
Placental complications. One example is placenta previa, in which the placenta blocks the cervix. This raises the risk that the placenta will become detached too soon from the uterus.
Twins or other multiples
Bayhealth is Southern Delaware’s healthcare leader with hospitals in Dover and in Milford. Bayhealth provides a wide range of medical services, including cardiovascular, cancer, orthopaedics and rehabilitation, pediatrics, respiratory care, sleep care, surgical weight loss and women’s services.