Merck Manual

Please confirm that you are not located inside the Russian Federation

honeypot link

Introduction to Complications of Labor and Delivery


Julie S. Moldenhauer

, MD, Children's Hospital of Philadelphia

Last full review/revision Jan 2020| Content last modified Jan 2020
Click here for the Professional Version

Usually, labor and delivery occur without any problems. Serious problems are relatively rare, and most can be anticipated and treated effectively. However, problems sometimes develop suddenly and unexpectedly. Regular visits to a doctor or certified nurse midwife during pregnancy make anticipation of problems possible and improve the chances of having a healthy baby and safe delivery.

Problems may involve

  • The timing of labor—whether labor occurs earlier or later than normal

  • Problems in the fetus or newborn

  • Problems in the mother

  • A problem with the placenta called placenta accreta

Placenta accreta may be discovered during pregnancy or only after delivery.

Most problems are obvious before labor begins. Such problems include

Some problems (complications) that women develop during pregnancy can cause problems during labor or delivery. For example, preeclampsia (high blood pressure with protein in the urine) may lead to premature detachment of the placenta from the uterus (placental abruption) and problems in the newborn.

Some problems develop or become obvious during labor or delivery. Such problems include

  • Amniotic fluid embolism (the fluid that surrounds the fetus in the uterus enters the woman’s bloodstream, sometimes causing a life-threatening reaction in the woman)

  • Shoulder dystocia (the fetus's shoulder lodges against the woman's pubic bone, and the baby is caught in the birth canal)

  • Labor that starts too early (preterm labor)

  • Prolapsed umbilical cord (the umbilical cord comes out of the birth canal before the baby)

  • Nuchal cord (the umbilical cord is wrapped around the baby's neck)

  • A fetus that is too large to pass through the birth canal (pelvis and vagina)—called fetopelvic disproportion

When complications develop, alternatives to spontaneous labor and vaginal delivery may be needed. They include

Some problems occur immediately after delivery of the fetus, around the time the placenta is delivered. They include

Timing of Labor and Delivery

No more than 10% of women deliver on their specified due date (usually estimated to be about 40 weeks of pregnancy). About 50% of women deliver within 1 week (before or after), and almost 90% deliver within 2 weeks of the due date.

Did You Know...

  • Only about 10% of women deliver their baby on their due date.

Labor may start

  • Too early (preterm): Before the 37th week of pregnancy

  • Late (postterm): After the 42nd week of pregnancy

In such cases, the health or life of the fetus may be endangered.

Labor may be early or late because the woman or fetus has a medical problem or the fetus is in an abnormal position.

Determining the length of pregnancy can be difficult because the precise date of conception often cannot be determined. Early in pregnancy, an ultrasound examination, which is safe and painless, can help determine the length of pregnancy. In mid to late pregnancy, ultrasound examinations are less reliable in determining the length of pregnancy.

NOTE: This is the Consumer Version. DOCTORS: Click here for the Professional Version
Click here for the Professional Version
Others also read

Test your knowledge

Breast Pain
Breast pain (mastalgia) may be localized to a small area of one breast or be more generalized and felt throughout one or both breasts. Which of the following is NOT one of the more common causes of breast pain?
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID

Also of Interest

Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID