The Birth Complications You Should Be Aware Of

Vaginal birth is not always straightforward. Jane Barry, midwife and child health nurse, explains what complications may happen during the birth of your baby and what signs to look out for.

Vaginal birth complications

Vaginal birth is the ideal way for babies to be born and brings many physical and psychological benefits to mothers and their babies. However, vaginal birth is not always straightforward and for some women can lead to complications soon after birth and even in later years.

Remember:  Every woman, her pregnancy and her baby are unique. As individuals, each pregnancy and birth is different. Unless there are clear reasons not to have a vaginal birth, or it would increase risks to a mother and her baby, most maternity care providers recommend women have a vaginal birth.

Why didn’t someone tell me?

It’s hard to know in the middle of labour and birth that having a vaginal birth may bring later complications. The focus at the time of course, is having a healthy, live baby and mother.

Sometimes it’s not until after the birth that problems can arise for mothers. Women often put their post birth symptoms down to birth recovery and exhaustion but the general guide for (physical) recovery after birth is around six weeks. By then, vaginal bleeding should have stopped and the uterus has returned to its pre pregnancy size and position.

Common vaginal birth complications

For the mother at time of birth:

Complications vary depending on the individual woman, her labour and birth. Some issues emerge after labour has started and others without any warning. This is why it’s so important to have the support of a qualified maternity care provider who uses evidence to form their practice and recommendations.

• High blood pressure – also called preeclampsia.
• Haemorrhage – if this happens before the baby is born, it’s called antepartum haemorrhage and postpartum haemorrhage if it happens after the baby’s birth.
• Labour which does not progress – also called failure to progress or FTP.
• Obstruction difficulties with the baby’s birth. This sometimes happens if a mother’s pelvis is small and she’s having a large baby. Sometimes called cephalo (head) pelvic disproportion or CPD.
• Maternal exhaustion to the point of not being able to push the baby out. Sometimes forceps or vacuum extraction are used to help the baby be born.
• Damage to the perineum – either from tearing or episiotomy.
• Damage to the mother’s pelvic floor.
• Vaginal fistula – this is where a prolonged labour can lead to changes in the blood supply between a mother’s vagina and her bladder or bowel and a hole or fistula forms. In developed countries where pregnancy and birth are monitored, vaginal fistula is very rare.

Complications for the baby

Occasionally, there are problems with the baby’s cord and it needs to be cut or freed from the baby before the baby is born.

Premature birth. Sometimes it’s not possible for premature labour to be halted and the baby is born vaginally.

The baby lying in another position than head down – the ideal position for a vaginal birth.

Babies can experience foetal distress, where their heart rate drops and they become stressed during the labour.

Occasionally the baby’s shoulders can become struck, which is known as shoulder dystocia. The baby may need assistance to turn and their shoulders to fit through the mother’s pelvis.

Birth injuries, for example, a fractured collarbone.

Later vaginal birth complications for mothers

• Urinary (wee) incontinence.
• Faecal (poo) incontinence. This can happen if a woman has had a 3rd or 4th-degree tear which extended into her anus.
• Haemorrhoids.
• Prolonged bleeding – this can be due to retained products of conception e.g. the membranes or a portion of the placenta being left in the uterus.
• Infection.
• Prolapse of the vagina, bladder, rectum and/or uterus.
• Loss of tone and changes in sensation during sex.

Symptoms of vaginal prolapse

Prolapse and urinary incontinence are more common in women who have had vaginal births. There are a few reasons for vaginal prolapse but it’s generally due to weakening of the muscles which support the organs in a woman’s pelvis. The bladder, rectum, uterus or vagina can all fall or bulge into the vagina, causing feelings of pressure, pain and incontinence. Around 1/3 of women who’ve had a vaginal delivery will develop some degree of vaginal prolapse.

There is a range of different treatment options for vaginal prolapse, from vaginal pessaries, pelvic floor muscle exercises, hormones and/or surgery.

Tissue damage during childbirth can become worse with increasing age and changes in a woman’s hormone levels. Prolapse is more likely for women who were pushing for a long time during their second stage of labour, or who gave birth to large babies. Multiple births, having many children and vaginal birth intervention can all increase the risk of prolapse.

Remember: Speak with your maternity care provider if you have any questions about your pregnancy, labour or birth. And if you’re still having complications after your baby’s birth, speak with them or your GP.

Jane Barry has qualifications in general, paediatric, immunisation, midwifery and child health nursing. She holds a Bachelor Degree in Applied Science (Nursing) and has almost 30 years specialist experience in child health nursing. She is a member of a number of professionally affiliated organisations including AHPRA, The Australasian Medical Writer’s Association, Health Writer Hub and Australian College of Children and Young People’s Nurses.

This article was first published in KidSpot and republished on theAsianparent with permission.

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