Complications During Labor and Delivery

Labor and delivery complications are relatively rare, but they do happen, and they're increasingly common. Most complications can be identified and managed to ensure the delivery is safe. However, some problems during labor are serious, even life-threatening, for a pregnant person and their baby.

It's normal to feel worried about the possibility that something could go wrong when you go into labor. You might already know that you have risk factors that could make a complication more likely when you give birth. Your health care provider may also have explained to you that some complications can happen even if you do not have an increased risk.

Here are a few of the more common labor and delivery complications that you might want to ask about, as well as what your care team will do to keep you and your baby safe.

Common Labor and Delivery Complications

There are a few types of labor and delivery complications that are more common than others. Early labor, issues with the placenta, bleeding problems, and fetal distress are a few examples.

Preterm Labor

Preterm labor starts before the 37th week of pregnancy. Sometimes, it can start as early as 20 weeks. According to the Centers for Disease Control and Prevention (CDC), about 1 in every 10 births was preterm in 2018.

Very premature babies have a number of challenges to overcome. Even after they leave the hospital, some will have developmental disabilities and persistent health problems.

At your prenatal visits, talk to your provider about the signs of premature labor and get instructions on what you should do if you experience them.

Labor That Does Not Progress

Having contractions and your water breaking are typical indicators that you are in labor. Sometimes, however, the process can come to a grinding halt. If you went into labor but are not progressing through the stages, your provider might want to give you medication to speed up your labor or restart it if it stopped.

Your labor might stall if:

• Your baby's head and the size of your pelvis are mismatched—a condition called cephalopelvic disproportion
• Your cervix is not dilating
• Your contractions aren't strong enough or are infrequent

You might need to have a C-section if your labor does not progress enough for you to deliver vaginally.

Placental Issues

Many placental issues are identified before a baby is born, though this is not always the case. Problems with the placenta can also occur once labor has started. Certain issues with the placenta are more common after uterine surgery, such as a C-section.

If they are not addressed, issues with the placenta can cause severe blood loss (hemorrhage) that can put the health of a pregnant person and their baby at risk. Before and during your labor, your care team will monitor you to ensure that any placenta problem is quickly identified and treated.

Umbilical Cord Problems

Problems with the umbilical cord can also cause labor and delivery complications. The cord might be wrapped around the baby's neck (nuchal cord), or the cord will come out of the vagina before the baby (prolapse).

If your care team identifies a problem with the baby's umbilical cord, there are steps that they can take to correct the problem and ensure the safe progression of labor. If an issue with the umbilical cord is not able to be fixed and your baby is showing signs of distress, you might need to have a C-section.

Perineal Tearing

Tearing of the tissues of your vagina and the perineal region (between your vagina and anus) can occur during vaginal delivery. The severity of a tear is categorized by a grading system. In some cases, it can be quite extensive and your provider will need to repair it with sutures (stitches) or another method.

Your provider might decide to make a cut in these tissues (episiotomy) as you are delivering to prevent them from tearing. Whether you have a tear or an incision is made, the wound will need time to heal and recover.

Bleeding Issues

If you experience excessive bleeding after giving birth, your provider will diagnose you with postpartum hemorrhage. There are certain risk factors for postpartum hemorrhage. You might be more likely to experience the complication if:

• You are pregnant with more than one baby (twins, triplets, etc.)
• You have a complication such as preeclampsia, anemia, or a problem with the placenta
• You have had more than 5 previous deliveries (grand multips)
• Your labor is prolonged or needed to be induced

Ask your provider how they handle bleeding in the postpartum period. Depending on what is causing the bleeding, your provider might start by massaging your uterus or giving you a medication to help stop the bleeding.

If these more conservative measures do not work, you might need to have surgery to remove the placenta and the uterine lining. In extreme cases where there is no other way to stop the bleeding, the uterus might need to be taken out completely (hysterectomy).

Fetal Distress

Fetal distress can have many causes, including umbilical cord issues, medications used during labor, and infections, as well as induction. If your baby is experiencing a complication such as perinatal asphyxia, breech positioning, or shoulder dystocia, they might also show signs of distress.

External fetal monitoring allows your care team to check on the baby and see how they are coping with labor. Other tests can also be used, including fetal scalp pH sampling and internal fetal monitoring.

If your baby is in distress and you are not close to giving birth, your provider might use forceps or a vacuum extractor to help you deliver. In some cases, a C-section might be required to ensure your baby arrives safely.

A Word From Verywell

Labor complications are uncommon but they can happen to anyone, in any delivery setting, and under the care of any type of provider. Certain risk factors can make it more likely that complications will develop, but if you have had a healthy pregnancy you will likely have an uncomplicated childbirth experience.

Even if you do not have any risk factors, it's important that you talk to your provider about what would happen if complications developed during your labor. Ask them how they handle emergency situations such as excessive bleeding and when they would recommend a C-section if your plan was to have a vaginal delivery.

Your care team is there to monitor you and your baby and ensure that you have a safe labor and delivery. You can start talking about any concerns you have during your prenatal visits. Discussing the possibility of complications during your labor might feel scary, but having a plan is one of the best ways to empower yourself.