Childbirth, complications of

Difficulties and problems occurring after the onset of labour. Some complications are potentially life-threatening, especially if they impair the baby’s oxygen supply (see fetal distress). Premature labour may occur, with the delivery of a small, immature baby (see prematurity). Premature rupture of the amniotic sac can lead to infection in the uterus, requiring prompt delivery of the baby and treatment with antibiotic drugs. Slow progress in the 1st stage of a normal labour due to inadequate contractions of the uterus is usually treated with intravenous infusions of synthetic oxytocin. If the mother cannot push strongly enough, or contractions are ineffective in the 2nd stage of labour, the baby may be delivered by forceps delivery, vacuum extraction, or caesarean section. Rarely, a woman has eclampsia during labour, requiring treatment with anticonvulsant drugs and oxygen, and induction of labour or caesarean section. Bleeding before labour ( antepartum haemorrhage) or during labour may be due to premature separation of the placenta from the wall of the uterus or, less commonly, to a condition called placenta praevia, in which the placenta lies over the opening of the cervix. Blood loss after the delivery ( postpartum haemorrhage) is usually due to failure of the uterus to contract after delivery, or to retention of part of the placenta. If the baby lies in the breech position (see breech delivery), caesarean section may be necessary. Multiple pregnancies (see pregnancy, multiple) carry an increased risk of premature labour and of problems during delivery. If the mother’s pelvis is too small in proportion to the head of her baby, delivery by caesarean section is necessary.