No one wants things to go wrong when it’s time to bring a new life into the world, but the truth is, sometimes things don’t always go as planned in the delivery room, particularly in the case of high-risk pregnancies. We spoke with Dr. George Mussalli, former Chairman of Obstetrics and Gynecology at St. Vincent’s Hospital in New York City and practicing obstetrician at Village Obstetrics, about the most seven common birth complications — and how you can overcome them.
Birth Complication #1: Fetal Heart Rate Tracing
Fetal tachycardia is a common complication where your baby has a baseline heart rate greater than 160 bpm and is considered a “non-reassuring pattern.” The birth complication can lead to monitoring or an emergency Cesarean birth, depending on the duration and rate of the heartbeat. When monitoring for fetal tachycardia, there are a few things you can do, including staying hydrated and using Pitocin.
Hydration is “especially important if you get an epidural because a mom with dehydration is at a higher risk for low blood pressure from the epidural which causes the fetal heart rate to drop and sometimes causes the doctor to do an emergency C-section,” says Mussalli.
And while many moms want to avoid Pitocin, Mussalli recommends being open to the benefits of using it if necessary. “Many times after an epidural, the contractions space out and weaken, and labor stalls,” he says. “Not using Pitocin after an epidural can sometimes lead to a C-section for inadequate progress of labor. Consider using low dose Pitocin after an epidural, not to speed up the labor, but just to keep it going. Remember the Pitocin contractions won’t hurt when you have a working epidural.”
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Birth Complication #2: Taking an Epidural Too Soon
“Try and delay an epidural until active labor — meaning you’ve reached six centimeters of cervix dilation — especially with your first vaginal birth,” Mussalli says. “Epidural can sometimes be associated with the head position not being ideal, like a ‘sunny side up’ baby where the dimensions are too big to fit through the pelvis.” Mussalli advises that the best way to avoid getting an epidural too early is to hire a doula — who will work with you and your doctor for a safe delivery.
Birth Complication #3: Waiting Too Long to Go to the Hospital
Once active labor hits, birth can take less than an hour, so manage your time. “Sometimes people assume that since the first birth was a grueling 40-hour ordeal that the second birth will be the same,” Mussalli says. “The reality is that the contractions will likely be much more manageable until you hit active labor and then birth might actually happen in less than an hour. This risks a crazy stressful transport to the hospital and sometimes a taxi birth.”
Birth Complication #4: Anemia
The increased demand for iron during pregnancy and the blood loss at delivery often leaves mothers anemic. “Anemia makes it harder to feel energetic and produce breast milk,” Mussalli says. He recommends having a diet full of iron-rich foods such as spinach, quinoa, red meat, and legumes. You can take iron supplements as well. Additionally, a CHC blood test during pregnancy can help detect the levels of iron and potential anemia.
Birth Complication #5: An Oversized Baby
Size is relative, but it’s important to do everything you can to keep your in-uterine baby from becoming too big for a natural birth. “To reduce the chances of having a macroscopic baby, pay attention to nutrition during pregnancy,” Mussalli says. “Keep daily carbohydrate intake to less than 175 grams/day and maintain daily protein intake to approximately 60g/day. This can help avoid excessive fetal and maternal weight gain and possibly reduce the risk of shoulder dystocia — which is when the baby becomes stuck in the birth canal.” Check your sonograms periodically during pregnancy to help detect the growth rate of the baby and use an app to track dietary proteins, fats, and carbs to help moms receive the best nutrition possible during pregnancy.
Birth Complication #6: The Perineum Tear
“Nobody likes to have a tear at delivery,” Mussalli says. “Avoiding routine episiotomy is important — be sure your provider reserves episiotomy only for appropriate times.” He also recommends that mothers try to practice techniques such as breathing exercises to help prevent you from having uncontrolled pushing when the baby’s head is crowning. Also, it may not be a bad idea to consider doing perineum massage in the last six weeks of pregnancy to help reduce tears at the birth.
Birth Complication #7: Having an Unrealistic Birth Plan
“One of the most common complications is a disappointing birth experience,” Mussalli says. “It may seem odd to list this as a complication, however, many couples carry around some emotional scars from a birth experience that did not go according to their plan.”
To avoid this, Mussalli says that it’s important for couples to formulate a birth plan by the 30th week of pregnancy. Then, discuss this plan with your medical provider so you can all be on the same page and avoid unrealistic expectations of what the birthing experience will be like.