Complications of childbirth

What is difficult childbirth?

Difficult labor refers to any deviation from the medically correct course of labor.
Pathologies during childbirth in women have become increasingly common in recent years. Negative environmental factors and abnormal fetal development often play a provoking role in the occurrence of such situations.

Complications during labor can occur both in the first half of the process and in the final stages.

Pathologies that occur while the child is in the mother’s birth canal are considered more dangerous. They pose a threat to the life and health of the baby.

Many people confuse difficult childbirth with severe pain. In the first case, doctors can predict the likelihood of a negative course even before the onset of labor.

Pain during the birth of a baby is considered normal and, if desired, can be eliminated with medications.

A complicated course of labor may be indicated by changes in the strength and nature of contractions, pain, vaginal discharge, disturbances in the woman’s general well-being, and fetal movements. With weak labor, the woman in labor notices rare short contractions, which are usually less painful. Discoordinated contractions are accompanied by a noticeable increase in myometrial tone, an abnormal rhythm of its contraction and relaxation, uneven strength of contractions and painful labor. Usually, the woman feels severe anxiety.

Although pain is always present during labor without anesthesia, changes in its intensity may indicate the development of complications. More often, severe pain syndrome occurs when uterine rupture threatens and has begun. Immediately at the moment of rupture, the pain decreases and myometrial contractions stop. If during childbirth or immediately after it a woman complains of sharp (“shooting”) pain in the area of the symphysis pubis, a divergence or rupture of the pelvic ring can be suspected.

The appearance of copious watery discharge from the vagina indicates the rupture of amniotic fluid. In contrast to the timely opening of the amniotic sac in normal childbirth, its premature rupture is considered a complication and often provokes a weakening of labor, prolapse of parts of the fetus or the umbilical cord into the vagina. Bloody discharge in the first stage of labor is usually a consequence of premature separation of the placenta. In the second period, they most often accompany ruptures of the birth canal, and in the third they arise as a result of myometrial hypotension or retention of parts of the placenta in the uterine cavity.

With the development of extragenital complications of childbirth, general changes in the woman’s well-being are observed. She may feel sudden weakness, dizziness, loss of clarity of vision, spots or blurred vision, palpitations, sweating, feeling cold, or trembling. In the intercontractual period and, especially, during contractions, fetal movements are usually not felt, but when hypoxia occurs, the discomfort experienced by the child forces him to actively move. Therefore, increased fetal activity in the period between contractions should be a cause for concern for the obstetrician-gynecologist.

What provokes

There are many reasons for complications during the birth process. The most common ones include:

insufficient contractile activity of the uterus, which provokes weak contractions;
oxygen starvation of the child;
narrow dimensions of the pelvis of a pregnant woman;
ruptures of the soft tissues of the birth canal;
prolapse of the umbilical cord tube;
large baby sizes.

Secondary causes of difficult childbirth:

mental and physiological unpreparedness of the mother for the birth of the baby;
the presence of infectious and inflammatory diseases in the female reproductive system;
the presence of pathologies during gestation;
the presence of tumor processes in the body.

For a successful delivery, a woman must prepare for it during pregnancy. It is important to cure all concomitant diseases and prepare mentally for the birth of a child.

It is important to regularly attend scheduled consultations with your doctor and get tested.

Recommendations

Before conception, it is recommended to prepare . Within 3 months, it is necessary to examine and treat all detected pathologies, follow the advice of your doctor.
Prepare thoroughly for childbirth , both mentally and physically. Try yoga, breathing exercises, educational training, art therapy.
If you still have a fear of childbirth, you can choose a doctor and/or midwife who will help you.
If necessary, it is recommended to see a psychologist or psychotherapist.
Preference should be given to partner births.
If you detect any deviations in behavior or development in a child, be sure to consult with a pediatrician, neurologist, or psychotherapist.

Signs

An experienced doctor can diagnose the incorrect course of the birth process almost immediately based on the characteristic symptoms. As a rule, such childbirth is accompanied by the following manifestations:

reduction or complete cessation of contractive activity;
stopping the baby's progress through the birth canal;
ruptures of the vagina, cervix and other soft tissues;
a sharp change in a woman’s blood pressure level;
bleeding.

In most cases, a woman giving birth should be alerted by a change in sensations. Increased or, conversely, cessation of pain. This is the first signal that the process has taken a different path and, possibly, the wrong one.

If a woman notices any changes during childbirth, she should immediately inform the doctors about them. Often timely medical assistance saves the life of the baby and his mother.

Causes

Let's consider the factors that can cause rapid and rapid labor:

Congenital (genetic) pathology of the muscle cells of the uterus, expressed in their increased excitability. As a result of this, uterine contractions occur more intensely than necessary. If a pregnant mother or other close relatives on the maternal side (sister, aunt, grandmother) had a rapid or rapid birth, then it may recur.
Increased excitability of the nervous system. Overexcitement, neuroses, the expectant mother’s lack of psychological readiness for childbirth - all this can affect the duration of labor.
Metabolic disorders and diseases of the endocrine system. Obesity and thyrotoxicosis (increased levels of thyroid hormones in the body) cause disruption of hormonal levels and endocrine regulation of labor, which can lead to accelerated labor.
Complicated obstetric and gynecological history. The pregnant woman has a history of inflammatory diseases (for example, salpingo-oophoritis - inflammation of the ovaries and fallopian tubes), abnormalities in the development of the uterus (saddle-shaped, bicornuate, duplication), abortion, miscarriage, termination of pregnancy in the past, diseases of the uterus (for example, fibroids - a benign tumor or adenomyosis ), menstrual irregularities, the last birth passed quickly.
Complicated course of pregnancy - kidney disease, gestosis (increased blood pressure, the appearance of edema and protein in the urine), polyhydramnios, multiple pregnancy, low-lying placenta, large fetus, placental insufficiency, Rh conflict (carrying a fetus with an Rh positive factor by a woman with Rh - a negative factor, as a result of which her body begins to produce protective antibodies, considering fetal cells to be foreign), post-term pregnancy.
The age of a primigravida woman is under 18 and over 30 years. This is explained by the fact that before the age of 18 the body is not yet ready for pregnancy and childbirth, and after 30 years, many women, as a rule, already have a history of inflammatory diseases of the genital organs, some chronic (for example, diseases of the endocrine glands, kidneys) .
Unreasonable or excessive use of drugs by medical personnel to induce labor.

Help with difficult births

Help during complicated childbirth may include the following:

medical;
self-help;
from the partner.

Medical assistance during difficult childbirth consists of eliminating the pathology or accelerating the birth of the child.

Sometimes it comes down to saving a life, but negative consequences cannot be excluded. The choice of medical care depends on the pathology that provoked a difficult birth.

If necessary, doctors can cut the perineum, apply forceps, or perform an emergency caesarean section.

A woman’s self-help is aimed at organizing proper breathing and maintaining a calm psycho-emotional state.

It is very important that a woman in labor promptly informs doctors about warning signs.

A partner can help a woman calm down and support her morally.

"I'm on my way or I'm late"

Premature delivery is also not uncommon these days. If labor occurs before the 37th week of pregnancy, then this is what they are - premature birth. Nagging pain in the lower abdomen, bleeding, vaginal discharge of clear fluid, cramping pain lasting more than 30 seconds - all these are harbingers that labor may occur right now. You should not be afraid of premature birth, because if you contact specialists in a timely manner, the lives of mother and child are safe.

Childbirth “on time” can also proceed rapidly, when the cervix opens in a matter of minutes, and attempts occur for which neither the woman in labor nor even her baby is ready. The exact opposite of rapid labor is labor with weak contractions, when the cervix dilates slowly, which means that the labor itself is delayed. With such a course of labor, the woman in labor has to be injected with stimulant drugs to increase uterine contractions.

How and why such complications occur is difficult to answer, but usually these “surprises” are easy to deal with.

How do they go

In the first stages, difficult labor, as a rule, is no different from the normal course of the process. During the labor period, women experience a decrease in the frequency and intensity of uterine contractions. Doctors monitor uterine tone using a CTG procedure.

To resume contractions, the woman is stimulated. If this does not bring the expected effect, the question arises of performing a caesarean section.

Sometimes complications arise as the baby passes through the birth canal. At this stage, tissue rupture, fetal movement cessation, and acute hypoxia may occur.

In such a situation, medical assistance should be very fast. Typically, the woman undergoes an emergency caesarean section.

Consequences

Pathological abnormal births are almost always accompanied by negative consequences for mother and child.
Complications for mom:

large blood loss;
violation of the integrity of the birth canal;
the likelihood of developing an infectious process;
discrepancy and disruption of the pubic symphysis;
death during childbirth.

Against the background of physiological complications, women often face psychological problems. They develop a fear of repeat childbirth, try to avoid sexual contact with a partner, and experience severe postpartum depression.

Consequences of a difficult birth for a child:

oxygen deficiency;
death of brain cells;
necrosis of tissues of internal organs as a result of oxygen starvation;
infection with infectious diseases during birth;
intoxication with drugs that were introduced into the mother’s body (anesthesia);
death of the fetus or newborn.

Prolonged labor: how is it dangerous for the baby?

My pregnancy with my first child was relatively smooth. However, at the last ultrasound I was warned that the baby would be rather large. At the last examination by the gynecologist, the estimated weight was about 4 kg. Contractions began immediately after 40 weeks, and with their onset I went to the maternity hospital on foot (luckily it was located two houses away from me). At the first examination, the doctor noted that labor had already begun, and I was immediately sent to the maternity ward. Then, for 9 hours, there were regular contractions, they were not as painful as everyone warned me. Even then I thought: why is everyone screaming so much, it practically doesn’t hurt. The sensations were about the same as during menstruation. Further, during the examination, the gynecologist said that the cervix had fully dilated and pierced the bladder, and said that within a maximum of half an hour I should already give birth. And then some kind of horror began. The child did not want to be born. My husband helped me during the birth; he shook me. During contractions, he and I screamed together. However, the midwife constantly repeated that the baby was not coming out, and I had to constantly push hard. After just a few minutes, my strength left me, but there was still no result. The doctor couldn't understand what was happening. The birth took place according to the classical scheme, and there were no signs of trouble. For 3 hours I could not give birth, although I had quite strong attempts. In the last hour, I practically lost consciousness with each of the attempts, it seemed that it would never end. However, the midwife said that I was not trying. It was no longer possible to perform a caesarean section, and I understood that in any case I would have to somehow give birth myself, but I no longer had the strength. The panic began. As a result, the doctor offered to give me an episiotomy - an incision in the vagina. Probably in a normal state this procedure is painful, but during childbirth I didn’t even feel any pain. After this, the process went faster, but the doctor was surprised to see the baby’s hand, along with the head, with which he was hugging it. Apparently this happened already during childbirth, since she was not there at the last ultrasound. After the episiotomy, within a few seconds the baby was born. He weighed 4100 and had a head volume of 36 cm, which is slightly larger than normal. Such a birth did not pass without a trace for him. It turned out that the collarbone of the arm that was raised had broken during childbirth. Also, due to a long period of pushing (normally it should be no more than 1-2 hours), he developed neurological complications: paresis of the facial nerve, weakness of the shoulder girdle. We spent the entire first year of his life treating complications from our difficult birth. Fortunately, we dealt with all the problems, and now he has grown up to be a handsome, athletic boy and is doing excellent at school.

Prevention

Compliance with recommendations for the prevention of complications during childbirth significantly reduces the risk of their development. A woman must follow the following rules:

before pregnancy, it is necessary to cure all existing diseases;
at the planning stage it is necessary to be tested for hidden infections;
future parents need to stop smoking and drinking alcohol;
after conception, a woman is recommended to immediately register with an antenatal clinic in order to undergo examinations in a timely manner;
follow all medical recommendations;
during pregnancy it is necessary to eat properly and balanced;
If you experience discomfort or bleeding, immediately inform your doctor;
It is recommended to attend a school for future parents for psycho-emotional preparation for the process.

In obstetric practice, complex births are quite common. As a rule, the likelihood of an incorrect course of the process can be assumed even at the stage of bearing a child.

Proper pregnancy planning and timely treatment of diseases significantly reduce the risk of difficult childbirth.

It is important to eliminate as much as possible the possibility of pathologies during the delivery process. They can have serious consequences for the health of the baby and his mother.

Consequences of a rapid birth for a baby

Consequences that can adversely affect the baby include the following:

Placental abruption, which can cause dangerous oxygen deprivation.
The baby may not have time to turn its head in the right direction after birth. Therefore, the shoulders may be slightly dislocated. Sometimes there are injuries to the collarbone, humerus, and vertebrae.
Due to the fact that the baby has to cross the birth canal extremely quickly, the bones of his small skull may not have time to properly adjust to the birth canal. The consequence of this is often birth injuries and intracranial hemorrhages.
Brain cells may die due to vascular spasms.
Damage to the bones of the skull can provoke the appearance of complications in the brain; deviations in the activity of the central nervous system may appear (the result may be paralysis, paresis).