It is a special moment, when parents enter the delivery room to give birth to their first child. For new parents, the experience of nine months of gestation results in a culmination of joy and exuberance at the hospital, despite the presence of labor pains and other discomforts for the mother.
Less than seventy years ago, it was not uncommon for women to give birth at home, surrounded by family and friends, and older women who had the experience to help a new mom deliver. Today, women are afforded state of the art technology in a hospital, which can elevate our sense of safety, and make us forget that there are always elements of risk during any medical event; which includes labor and child birth.
Despite giving birth in hospital, surrounded by experienced medical professionals, there are still elements of risk during both the labor and the delivery process. What are some of the most common labor complications, and how can they be reduced or avoided entirely? We will discuss what young parents should be aware of in terms of quality health care, and the arrival of a first child, and some of the hazards of prolonged labor, versus other methods of delivery.
Pre-Term Labor and Premature Delivery
Carrying an infant to full-term for nine months, is the goal to ensure that infant development is complete, including the development of organs and the baby’s immune system. According to the Centers for Disease Control and Prevention (based on 2015 statistics), delivery before 37 weeks of pregnancy impacts about 1 in every 10 infants that are born in the United States. Researchers also note that the rate of premature delivery is higher among African-American women (13%) than by Caucasian women, who experience a 9% rate of pre-term delivery.
The organs most impacted by a pre-term delivery are the brain, the lungs and the liver, which are the last to develop in an infant. Approximately 36% of infant deaths annually are attributed to premature delivery, and the health risks for preemies include:
- Cognitive impairment and learning disabilities
- Breathing problems
- Feeding and digestive issues
- Vision and hearing impairments
- Cerebral Palsy
Researchers report some high-risk factors that contribute to premature birth rates in America. For instance, mothers who are below the average maternal age (very young) or women of a high age (over 45) are at increased risk for premature delivery. Other factors that contribute to premature birth rates are:
- Drug and alcohol abuse
- Tobacco use
- Hypertension (high-blood pressure)
- An infection or virus
- Multiple births (twins or triplets)
- A previous history of pre-term delivery
First time mothers who think they have experienced preterm labor symptoms should seek treatment immediately from their family physician. For women with a prior history of preterm delivery, progesterone treatments have been shown to help delay labor.
Abnormal Presentation During Delivery
The female reproductive system is designed to deliver a baby head first. The reason that it is important for an infant to breach the birth canal head first, is that the head is the largest part of the body; it ensures that the rest of the body will be able to fit through the canal, after widening to accommodate the child’s head.
Emerging feet first during labor is called a ‘breech birth’ and it is a serious medical concern for the infant, and the mother. There are four distinct breech positions which can present themselves during labor, or in the weeks prior to delivery:
- The Frank Breech indicates that the infant’s buttocks are pointed into the birth canal, while both knees are extended.
- A Complete Breech indicates a position where both the infant’s knees and hips are flexed, and the feet or the buttocks may be delivered first, if not corrected.
- An Incomplete Breech refers to one or both feet that lead the way through the birth canal.
- A serious and uncomfortable position is the Transverse Lie, where the infant extends or stretches out horizontally across the uterus, laying parallel instead of in a vertical delivery position.
During final labor and delivery, an infant can be maneuvered into a correct position for delivery in most cases. If the medical team is unable to reposition the baby, a natural birth may be bypassed for an emergency C-section. The surgical procedure is reserved to expedite delivery, particularly when asphyxiation is a potential risk for the child.
The Umbilical Cord Prolapse
The position of the umbilical cord is important to ensuring the safe delivery of an infant. Air (oxygen) food and blood are supplied to a baby through the umbilical cord, and ideally, the cord will emerge after the infant has breached the birth canal.
An emergency develops when the umbilical cord begins to emerge before the infant, or if it becomes pinched while in the birth canal. In this instance, an immediate delivery by best method will occur to prevent the child from suffering injury from restrictions to blood flow or oxygen.
For some women, the gestational period for the infant can seem like forever. For other women, a post-term pregnancy that extends past 42 weeks typically presents low risk for the infant, as it is fully developed. However, in some cases, the umbilical cord can collapse, cutting off vital nutrients to the child, increasing the risk of cognitive injury through oxygen deprivation.
Rather than allowing a pregnancy to go too far into post-term, most physicians will induce labor to reduce risks and provide a timely, scheduled birth.
First time parents should be prepared to take preparatory classes, ask for advice and read about some of the inherent risks involved with pregnancy and delivery. Women should seek medical treatment as soon pregnancy is confirmed, to monitor progress and follow nutritional and healthcare recommendations for a healthy, successful full-term pregnancy and delivery.