Frequently Asked Questions About Common Problems During Labor

• Things that can help speed up labor are changing positions, rest, or getting extra fluid through your IV.
• Your provider may need to perform an amniotomy. This is when they break your bag of water with a small hook, like a crochet needle. This does not hurt. This may shorten your labor. This is done when the baby’s head is high enough in your pelvis to be safe.
• You may need to be given oxytocin (pitocin). (see above)
• Your provider may use an intrauterine pressure catheter. This is a small tube that your provider puts inside your uterus that shows how strong your contractions are.
• You may need a cesarean birth (C-section) because other treatments did not help. (see below)

• Things that can help speed up labor are changing positions, rest, or getting extra fluid through your IV.
• Your provider may need to perform an amniotomy. This is when they break your bag of water with a small hook, like a crochet needle. This does not hurt. This may shorten your labor. This is done when the baby’s head is high enough in your pelvis to be safe.
• You may need to be given oxytocin (pitocin). (see above)
• Your provider may use an intrauterine pressure catheter. This is a small tube that your provider puts inside your uterus that shows how strong your contractions are.
• You may need a cesarean birth (C-section) because other treatments did not help. (see below)

Episiotomy. This is a small cut in your vagina that makes more room for the baby to be born. Most women do not need an episiotomy. Episiotomies can increase the risk of deep tears in the vagina. Tears into the rectum can cause problems with holding gas or bowel movements.

Forceps or a vacuum cup. These are tools placed on the baby’s head to help pull the baby out while you push to help the baby be born quickly. While most babies do fine with forceps or a vacuum cup, there are potential risks. Forceps may bruise your baby’s skin or, in rare cases, hurt a nerve in your baby’s face. The vacuum cup may cause swelling on your baby’s scalp or, in rare cases, hurt blood vessels in your baby’s head. Forceps or a vacuum cup may increase the risk of hurting the muscles in your pelvis.

Cesarean birth (C-section). C-sections are when your doctor makes a cut through your skin and uterus to deliver your baby. This happens in about 1 out of every 3-4 births. Some C-sections are planned before labor and others happen during labor.

• Some reasons why your baby may need to be delivered via C-section include:
  • Your baby has a problem in pregnancy or in labor.
  • Your labor stops.
  • You had a C-section before and need to have one again.
  • Your baby is not in the right position.
  • You have a medical problem.
• What problems can a C-section cause?
  • Blood loss
  • Infection
  • Pain after C-section
  • Scar tissue (this can make other abdominal surgeries harder to do)
• Rare problems include:
  • Damage to your bladder, intestines, or blood vessels
  • A small cut on your baby
  • Hysterectomy (surgery to remove your uterus) (1-2 out of 1000)
  • Death (1 out of 10,000)
• Can I have a vaginal birth after a C-section?
  • In many cases, yes. Although rare (less than 1 out of 100), the scar on your uterus can tear in labor. You are more likely to tear if you have had more than one C-section. Your midwife or doctor will talk to you about the chance of having problems in your next pregnancy.

An infection in your uterus may cause a fever. Your provider may give you antibiotics through your IV. Your baby may also need IV antibiotics after birth. This happens in about 2-3 out of 100 vaginal births. Infections are more common after a C-section and all women receive antibiotics to prevent infection.

When the baby’s head is born but the shoulder gets stuck behind your pubic bone, this is called shoulder dystocia. This is an emergency. This happens in 2 out of every 100 births. Your provider may ask you to change your position. They might cut an episiotomy. Your baby’s collar bone could break during birth. This almost always gets better on its own. Sometimes pressure on the baby’s shoulder can hurt a nerve in your baby’s arm. Mostly the nerve gets better with physical therapy. In rare cases, brain damage or death can happen when a baby stuck for a long time

• Many women have small tears in the vagina during birth.
• Sometimes an episiotomy is recommended.
• Your provider will check your vagina for tears after your baby is born.
• You may need stitches to heal the tear. The stitches dissolve on their own. A cold pack helps with soreness on the first day.

• Massage. Your provider may massage your uterus to help it to contract.
• Oxytocin and other medicines. These medicines can stop your uterus from bleeding.
• The placenta may be stuck inside and your provider may need to reach inside the uterus to remove it. This is not very common.
• Dilation and Curettage. This is surgery to take out any tissue left in your uterus after birth. It can help to stop the bleeding. Dilation and curettage may increase your risk of infection and damage to your uterus, bladder, or intestines.
• Blood transfusion. This is when you get new blood to replace the blood you lost. This occurs in 4 out of every 1000 births.
• Hysterectomy. This is when your doctor removes your uterus to stop the bleeding. Very few women need a hysterectomy (1-2 out of 1000).

• Most babies start breathing by themselves after birth. Sometimes babies need extra help, known as neonatal resuscitation. Your provider may give your baby oxygen through a mask, or place a tube in the baby’s lungs (intubate) to help them breath.
• Meconium is baby’s first bowel movement. The baby may pass meconium in the water before birth. If this happens a pediatrician will be at your baby’s birth in case the baby needs help breathing.
• We have special pediatricians working in the hospital who can take care of your baby in case of an emergency.

Our goal is to provide the safest possible birth for you and your family. Although most women give birth without major complications, we cannot predict how your birth will go and there may be unexpected outcomes. This information is to inform you of possible complications at the time of birth. You have been given the opportunity to review this document and ask your provider questions before signing the consent for labor.