Common Labor Complications and Challenges in the Labor Room

labor room

No one knows what labor will be like until they experience it. A labor room sees different types of birthing experiences. For some, it is easily manageable and relatively short. For others, it can be long and complication-laden. Regardless of how smooth or difficult labor maybe, several possible complications can arise.

The U.S. welcomes around 2.5 million babies born through natural vaginal delivery per year. In some cases, interventions such as vacuum extraction or forceps assisted delivery. These tools can help when the baby is in distress or when the mother is having difficulty pushing. In other cases, a C-section may be necessary if there are complications with the baby, placenta, or umbilical cord.

But what are the complications that can occur during labor, and how can they be managed or treated?

Prolonged Labor:

Also called “failure to progress,” prolonged labor is when dilation and effacement of the cervix slowly. Failure to progress occurs during the first two stages of labor. If it occurs during the first stage, it causes fatigue. Whereas during the second stage, it can be more dangerous for the mother and child when the baby passes through the birth canal.

The American Pregnancy Association defines prolonged labor as lasting more than 20 hours in the case of first birth. However, the time is cut down to no more than 14 hours for a second-time delivery.

In many cases, a labor and delivery nurse can use medical interventions such as Pitocin (synthetic oxytocin) to help speed up the process.

There can be several reasons for prolonged labor, such as the mother’s age, weight, or pelvic shape. In some cases, the baby may be large or in a posterior position.

Studies suggest that around 8% of women experience prolonged labor.

Fetal Distress:

Unresponsiveness of the fetus to the contractions can indicate fetal distress. It is one of the most common indications for an emergency C-section.

Pregnancies that last for more than 42 hours are at an increased risk for fetal distress. Other risk factors include infection, umbilical cord problems, high blood pressure, and diabetes.

During labor, the baby’s heart rate is monitored. A high heart rate can be an indication of fetal distress. If the baby’s oxygen level drops, it can lead to a heart rate that is too low, known as bradycardia.

Treatment for fetal distress depends on how severe it is. The mother may be given oxygen to help the baby in some cases. If the problem persists, a C-section may be necessary to prevent further distress or injury to the baby.

Perinatal Asphyxia:

A situation defined by the deprivation of oxygen to the baby during labor, perinatal asphyxia is a leading cause of newborn mortality. It can occur for several reasons, such as umbilical cord problems, placental abruption, or maternal high blood pressure.

Severe cases of perinatal asphyxia can lead to cerebral palsy, seizures, and intellectual disabilities. The baby may have low Apgar scores at birth and require oxygen or other medical interventions in milder cases.

Depending on the severity of the problem, doctors and nurses may decide on a treatment method. In some cases, the baby may only require supplemental oxygen. If the asphyxia is more severe, the baby may need to be intubated and put on a ventilator.

Shoulder Dystocia:

Shoulder dystocia is a complication during the second stage of labor. When the baby’s head delivers, one or both shoulders get stuck.

It is a serious complication as it can cause oxygen deprivation and even death to the baby. It is also a leading cause of neonatal brachial plexus injury, an injury to the nerves in the shoulder area.

The risk factors for shoulder dystocia include obesity, diabetes, and macrosomia (a condition where the baby is larger than average).

In many cases, shoulder dystocia can be managed with different techniques, such as suprapubic or fundal pressure. However, some other cases may require an episiotomy (a surgical cut made in the perineum) may be necessary to deliver the baby.

Excessive Bleeding:

On average, a total of 500ml of blood is lost during childbirth. However, some mothers may experience excessive bleeding (also known as postpartum hemorrhage), which can be dangerous. The period for excessive bleeding is defined as losing more than 500ml of blood within the first 24 hours after delivery.

Excessive bleeding can occur for uterine atony (a condition where the uterus doesn’t contract properly after delivery), lacerations, or retained placenta.

As a result of excessive bleeding, a woman may face organ failure or death. To prevent either, doctors aim to stop bleeding as soon as possible. Uterine massage and medications are the two most commonly practiced methods to stop postpartum hemorrhage. However, a more invasive approach like surgery or tying off bleeding blood vessels may be required in some cases.

Summing Up:

Birthing complications, while scary, are relatively common. Most of them can be managed with different interventions and techniques. However, some of them may require more invasive methods like surgery.

Mothers need to be aware of the different complications that can occur during labor to be prepared if anything happens.

Although, there is no reason you should live in fear of complications. The majority of births are complication-free and result in the safe delivery of a healthy baby. So, try to relax and enjoy the ride!

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