Preparing for the Unexpected During Birth

Most labors go well, but sometimes unexpected things happen. Knowing what to expect can help you feel more prepared.

Think about how to make a choice if something unexpected comes up, like any of the below.

We want you to have the safest and best birth experience. Most people give birth without problems, but we want you to know what might happen, so you feel prepared. You are always welcome to ask questions. We are here to support you and your baby every step of the way. You can review this information and ask your provider any questions before signing the consent form for labor.

Labor Slows Down

Sometimes, labor can slow down. Here are ways your care team may:

Help you change positions, rest, or get more fluids through your IV
Break the bag of water (amniotomy): This is when your provider uses a small hook to break your bag of water. It should not hurt, and it can help labor move faster.
Give oxytocin (Pitocin): This medicine helps make your contractions stronger.
Use an intrauterine pressure catheter (IUPC): This tiny tube goes into your uterus to measure how strong your contractions are.
Cesarean birth: If other treatments do not work, your baby may need to be born by C-section.

Problems with Baby’s Heartbeat

If your baby’s heartbeat changes, your care team may:

Help with position changes, rest, or getting more fluids
Break the bag of water (amniotomy) if it helps the baby move down
Give oxytocin (Pitocin): This medicine helps make your contractions stronger.
Use an intrauterine pressure catheter (IUPC): This tiny tube goes into your uterus to measure how strong your contractions are.
Perform a C-section birth if needed to keep you and your baby safe

Baby Needs to Be Born Quickly

Sometimes, your baby may need extra help to be born quickly if there is an emergency.

Here’s how your provider may help:

Episiotomy: A small cut in your vagina to make more room. Most people do not need this (it happens in about two to five of every 100 births), but sometimes it helps the baby be born safely.
Forceps or vacuum cup: These tools gently help pull your baby out. They are used if pushing is not enough, which happens in about two to five of every 100 births. There are some risks, but most babies do well.
Cesarean birth: If baby needs help to be born right away or if other options don’t work, a Cesarean birth may be the safest choice. A C-section is needed in about one out of every three to four births.

Fever During Labor

A fever during labor may mean you have an infection. If this happens:

Your provider may give you antibiotics through your IV
Your baby may need an IV and antibiotics after birth

This happens in about two to five out of 100 births. It is more common with C-sections.

Vaginal Tears

Many people have small tears during birth. Your provider will check for tears and may use stitches to help them heal.

These stitches dissolve and come out on their own.

Baby Gets Stuck

If your baby’s head is born, but the shoulders get stuck, it is called shoulder dystocia. This happens in about two out of every 100 births.

Your provider may:

Help you change positions or recommend an episiotomy (vaginal cut)
Use gentle moves to help your baby be born. This can include pressing on your pubic bone or helping your baby’s arm come out first.

Sometimes, your baby’s collar bone may break, but it usually heals on its own. Rarely, a nerve in your baby’s arm may get hurt, but it usually gets better with therapy.

Bleeding Too Much After Birth

Heavy bleeding can happen after birth. This is called a hemorrhage.

This happens in about 15 out of 100 births.

Here’s how your provider may help:

Uterine massage: Rubbing your belly to help your uterus contract
Medicines to help stop bleeding
Uterine balloons to stop bleeding: A uterine balloon is a soft, inflatable device that can be placed inside the uterus to help stop heavy bleeding after birth.
Removing the placenta: If it is stuck, your provider may need to take it out.
Dilation and curettage (D&C): A small surgery to take out placenta or tissue
Blood transfusion: If you lose too much blood, you may get new blood. This happens in four out of 1,000 births.
Hysterectomy: In very rare cases, the uterus may need to be removed to stop the bleeding. This only happens in one to two out of every 1,000 births.

Cesarean Birth

A Cesarean birth, or C-section, is when your provider makes a cut through your belly and uterus to deliver your baby.

This happens in about one out of every three to five first births
It may be planned ahead or decided during labor

Via BabyCenter, watch a short video showing how Melisha gives birth to her child via C-section:

Watch Video (Contains Medical Situations and Nudity)

Why Might You Need a C-Section?

Your baby’s heart rate is abnormal during labor
Labor may slow down or stop, even if you get medicine to help it move along
Your baby is not in the right position
You had a C-section before
You have a medical problem

Risks of a C-Section

Blood loss
Infection
Pain after surgery
Scar tissue
Rare risks:
- A small cut on the baby
- Damage to other organs (bladder, intestines)
- Hysterectomy (one to two out of 1,000 births)
- Death (one out of 10,000 births)

Help for Baby After Birth

Most babies start breathing on their own after birth but sometimes, babies need extra help. This is called neonatal resuscitation. Your provider may:

Give your baby oxygen through a mask
Place a small tube in your baby’s lungs to help them breathe

Sometimes, babies pass meconium, which is their first bowel movement, in the water before birth. If this happens, a pediatrician will be at the birth to make sure your baby is breathing well.

Special pediatricians (neonatologists) at the hospital are ready to take care of the baby if there is an emergency.