We all know that giving birth rarely happens like it does on TV shows: Your water breaks; you gasp, exclaim, “She’s coming!” Then, lipstick refreshed, you cradle your newborn as your handsome husband looks on. Alternatively, we hope your experience isn’t going to be fodder for reality TV: A swarm of doctors sprints into the delivery room, shouting, “Get the NICU team, STAT! We’ve got a quadruple nuchal and need a cold-knife section!”
More than likely, it will be somewhere between the two. However your labor story unfolds, being educated helps. Below are six possible scenarios of labors with complications, complete with doctors’ lingo and happy endings.
1. Fetal Distress
What it means: “ ‘Fetal distress’ is an older, vague term that OBs don’t generally use anymore,” says Nanci Levine, M.D., an OB-GYN at Montefiore Medical Center in Westchester, N.Y. “If you do hear it, ask for specifics.” The term often has to do with the fetal heart rate; it’s assumed the baby is in some kind of peril when the heart rate is slow, for example, or doesn’t return to normal following a contraction.
Frequency: “True fetal distress implies urgency— ‘I’m really worried about this baby right now’—and that doesn’t happen very often,” Levine says.
Likely remedies: If your cervix is fully dilated and the baby’s head is low, your doctor or midwife may use forceps or a vacuum extractor (a soft suction cup placed on the baby’s head) to deliver the baby quickly. Otherwise, it’s a Cesarean section for you.
2. Breech Position
What it means: The baby is positioned in the uterus head up, bottom down; sideways; or feet first. It’s also known as “malpresentation.”
Frequency: Rare (4 percent)
Likely remedies: Some doctors and midwives say getting on all fours to elevate your hips above your heart, then lowering yourself onto your forearms, encourages the baby to turn. At 37 weeks to 38 weeks, some doctors try external version—turning the baby manually by applying pressure to the mother’s abdomen. If that doesn’t work or the baby flips back, the doctor can try again or schedule a C-section. Very few OBs will attempt a vaginal delivery for fear that the baby’s head will get stuck in the birth canal.
3. Placenta Previa
What it means: The placenta is covering the cervix.
Frequency: Placenta previa is found early in pregnancy about 75 percent of the time. Usually, by the end of pregnancy, the placenta will correct itself.
Likely remedies: If the placenta is covering the cervix at 36 weeks, a C-section will likely be scheduled, says Leslie Goldstone-Orly, M.D., an OB- GYN at Bridgeport Hospital at Yale-New Haven in Bridgeport, Conn. “If the mother is bleeding vaginally, however, she should have a C-section immediately because there can be significant blood loss,” she adds.