Expecting the Unexpected: When Your Delivery Doesn't Go As Planned

No one expects to have trouble in the delivery room. In fact, many pregnant women may not really know what to expect from their own delivery experience. While you shouldn't live in fear of every possible thing that could go wrong during delivery, it is a good idea to educate yourself about all possible outcomes. The first step to being better able to cope with the unexpected during labor and delivery is to know what conditions can come about.

Seven Common Delivery Problems to Consider

Sometimes, birthing doesn't go as planned. Here are some common delivery problems and helpful information about each.

Shoulder Dystocia: Shoulder dystocia occurs when you have delivered your baby's head but his shoulder remains stuck behind the pubic bone. "This disorder may be the result of a large infant, particularly with maternal diabetes, but may also occur with normal size infants," says Dr. Jack FitzSimmons, MD, director of maternal-fetal medicine at Drexel University College of Medicine in Philadelphia. This is a condition that must be dealt with right away in the delivery room as it carries several risks, such as perineal tears and postpartum hemorrhage for Mom and a broken clavicle or brain damage from lack of oxygen for Baby.

Several techniques are often used to birth a baby in this situation. A popular choice is called the Gaskin maneuver, according to Dr. Anne B. Broussard, CNM, DNS, of the University of Louisiana at Lafayette. This technique involves having the laboring mother get on her hands and knees, which allows the pelvic outlet to open. "A supported squat position works well also in opening the pelvic outlet," says Dr. Broussard.

If alternate labor positions do not work, the caregiver may reach in and turn the baby's shoulder forward so it is no longer stuck behind the pubic bone. The baby's arm may also be pulled out so the shoulder diameter is decreased.

Breech: A baby is breech when she is turned around in the womb, necessitating that you deliver your baby's feet first. This can occur quite easily, as the baby moves around in the uterus and may end up breech when its size doesn't allow it to move back into the head down position, says Dr. Broussard.

If your baby is breech at the time of delivery, a procedure called external version is performed to help turn the baby around. The caregiver will nudge the baby into the head down position externally by pushing on the abdomen, says Dr. Broussard. Also, a tocolytic, or drug that helps to relax the uterus, may be administered to carry out the external version procedure.