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Understanding Labor and Delivery Complications -- the Basics

What Are Common Labor and Delivery Complications?

A pregnancy that has progressed without any apparent hitch can still give way to complications during delivery. Here are some of the most common concerns:

Preterm Labor and Premature Delivery

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One of the greatest dangers a baby faces is being born too early, before his or her body systems are mature enough to ensure survival. The lungs, for example, may not be able to breathe air, or the baby's body may not generate enough heat to keep warm.

A full-term pregnancy normally lasts about 38 to 40 weeks. Having labor contractions before 37 weeks of pregnancy is called preterm labor. A baby born before 37 weeks of pregnancy is considered a premature baby who is at risk of complications of prematurity, such as immature lungs, respiratory distress, and digestive problems.

Prolonged Labor (Failure to Progress)

A small percentage of women, mostly first-time mothers, may experience a labor that lasts too long, sometimes called "failure to progress." Both the mother and the baby are at risk for several complications, including infections, if the amniotic sac ruptures and the birth doesn't follow.

Abnormal Presentation

"Presentation" refers to the part of the baby that will appear first from the birth canal. In the weeks before your due date, the fetus usually drops lower in the uterus. Ideally, for labor, the baby is positioned head-down, facing the mother's back, with its chin tucked to its chest and the back of the head ready to enter the pelvis. That way, the smallest possible part of the baby's head leads the way through the cervix and into the birth canal. This normal presentation is called vertex (head down).

Because the head is the largest and least flexible part of the baby, it's best for the head to lead the way into the birth canal. That way, there's little risk that the baby's body will make it through the birth canal, but the head will get hung up.

Some fetuses present with their buttocks or feet pointed down toward the birth canal. This is called a breech presentation. Breech presentations are commonly observed during an ultrasound exam far before the due date, but most babies will turn to the normal head-down presentation as they get closer to the due date.

Frank breech. In a frank breech, the baby's buttocks lead the way into the pelvis; the hips are flexed, the knee extended.
Complete breech. In a complete breech, both knees and hips are flexed, and the baby's buttocks or feet may enter the birth canal first.
Incomplete breech. In an incomplete or footling or breech, one or both feet lead the way.
Transverse lie. A few babies lie horizontally in the uterus, called a transverse lie, which usually means the baby's shoulder will lead the way into the birth canal rather than the head.