Usually, labor and delivery Overview of Labor and Delivery Although each labor and delivery is different, most follow a general pattern. Therefore, an expectant mother can have a general idea of what changes will occur in her body to enable her to deliver... read more occur without any problems. Serious problems are relatively rare, and most can be anticipated and treated effectively. However, problems sometimes develop suddenly and unexpectedly. Regular visits to a doctor or certified nurse midwife during pregnancy make anticipation of problems possible and improve the chances of having a healthy baby and safe delivery.
Problems may involve
The timing of labor Timing of Labor and Delivery Usually, labor and delivery occur without any problems. Serious problems are relatively rare, and most can be anticipated and treated effectively. However, problems sometimes develop suddenly... read more —whether labor occurs earlier or later than normal
Problems in the fetus or newborn
Problems in the mother
Placenta accreta may be discovered during pregnancy or only after delivery.
Most problems are obvious before labor begins. Such problems include
Prelabor (premature) rupture of the membranes Prelabor Rupture of the Membranes (PROM) Prelabor rupture of the membranes is the leaking of amniotic fluid from around the fetus at any time before labor starts. After the membranes rupture, labor often soon follows. If labor does... read more (the mother's water breaks too soon)
Postterm pregnancy and postmaturity Postterm Pregnancy and Postmaturity A postterm pregnancy is one that lasts 42 weeks or more. In postmaturity, the placenta can no longer maintain a healthy environment for the fetus because the pregnancy has lasted too long. On... read more (a pregnancy continues longer than normal, sometimes causing problems with the baby)
Abnormal position and presentation of the fetus Abnormal Position and Presentation of the Fetus Position refers to whether the fetus is facing rearward (toward the woman’s back—that is, face down when the woman lies on her back) or forward (face up). It’s important to check the baby’s... read more (the fetus is in the wrong position for the safest delivery)
Some problems (complications) that women develop during pregnancy can cause problems during labor or delivery. For example, preeclampsia Preeclampsia and Eclampsia Preeclampsia is new high blood pressure or worsening of existing high blood pressure that is accompanied by excess protein in the urine and that develops after the 20th week of pregnancy. Eclampsia... read more (high blood pressure with protein in the urine) may lead to premature detachment of the placenta from the uterus (placental abruption Placental Abruption Placental abruption is the premature detachment of a normally positioned placenta from the wall of the uterus, usually after 20 weeks of pregnancy. Women may have vaginal bleeding and/or severe... read more ) and problems in the newborn.
Some problems develop or become obvious during labor or delivery. Such problems include
Amniotic fluid embolism Amniotic Fluid Embolism Amniotic fluid embolism occurs when some amniotic fluid that contains cells or tissue from the fetus enters the woman’s bloodstream and causes a serious reaction in the woman. (Amniotic fluid... read more (the fluid that surrounds the fetus in the uterus enters the woman’s bloodstream, sometimes causing a life-threatening reaction in the woman)
Shoulder dystocia Shoulder Dystocia Position refers to whether the fetus is facing rearward (toward the woman’s back—that is, face down when the woman lies on her back) or forward (face up). It’s important to check the baby’s... read more (the fetus's shoulder lodges against the woman's pubic bone, and the baby is caught in the birth canal)
Prolapsed umbilical cord Prolapsed Umbilical Cord Prolapse of the umbilical cord means that the cord precedes the baby through the vagina. A prolapsed umbilical cord occurs in about 1 of 1,000 deliveries. When the umbilical cord prolapses,... read more (the umbilical cord comes out of the birth canal before the baby)
A fetus that is too large to pass through the birth canal (pelvis and vagina)—called fetopelvic disproportion
When complications develop, alternatives to spontaneous labor and vaginal delivery may be needed. They include
Forceps or a vacuum extractor (called operative vaginal delivery Operative Vaginal Delivery Operative vaginal delivery is delivery using a vacuum extractor or forceps. A vacuum extractor consists of a small cup made of a rubberlike material that is connected to a vacuum. It is inserted... read more ) to deliver the baby
Some problems occur immediately after delivery of the fetus, around the time the placenta is delivered. They include
Timing of Labor and Delivery
No more than 10% of women deliver on their specified due date (usually estimated to be about 40 weeks of pregnancy). About 50% of women deliver within 1 week (before or after), and almost 90% deliver within 2 weeks of the due date.
Labor may start
In such cases, the health or life of the fetus may be endangered.
Labor may be early or late because the woman or fetus has a medical problem or the fetus is in an abnormal position.
Determining the length of pregnancy can be difficult because the precise date of conception often cannot be determined. Early in pregnancy, an ultrasound examination, which is safe and painless, can help determine the length of pregnancy. In mid to late pregnancy, ultrasound examinations are less reliable in determining the length of pregnancy.
