Reference Work Entry

Encyclopedia of Child Behavior and Development

pp 254-255

Birth Complications

  • Renee GrizzleAffiliated withBall State University

Synonyms

Abnormal presentation; Atypical delivery; Birth trauma

Definition

Any atypical feature of birthing process which increases the risk, impacts the delivery, health, or vitality of the infant, and is seen as a complication.

Description

Many factors may place the fetus at risk of poor outcomes. These may arise as a result of abnormal prenatal development in addition to atypical factors that can occur during the birthing process. The major complications of the birth are:

Cesarean delivery: In a cesarean delivery (c-section) the baby is surgically removed from the uterus by making an incision in the abdomen of the mother. This type of delivery is used most often when the fetus is in distress or danger and medical professionals feel it is unwise to wait for the baby to travel through the birth canal [25, 7]. Caesarean deliveries are also used when the baby is in a breech position (feet or buttocks first), transverse position (crosswise), or the head of the baby is too large to travel through the birth canal [24, 7]. Although the mother and baby require more time for recovery than is typically needed in a vaginal birth, the number of cesarean deliveries increases internationally each year. Labor exceeding 24 h is an indication of the need for a c-section due to the stress placed upon the infant [2].

Oxygen deprivation (anoxia): Breathing problems can occur during or after the birth process. Anoxia can be caused by Rh factor incompatibility between the mother’s and baby’s blood types or by entanglement of the umbilical cord during labor [1]. In addition, premature separation (abruption) of the placenta can cause inadequate oxygen supply to the baby and become life threatening without immediate medical intervention. Teratogens such as tobacco and cocaine have also been associated with anoxia. Newborns can also fail to start breathing upon delivery which may result in brain injury and long-term physical and cognitive deficits [13].

Low-birthweight and very-low-birthweight infants: Low-birthweight infants weigh less than 5½ lb compared to the average newborn weight of approximately 7½ lb. Approximately 7% of newborns in the United States can be characterized as low-birthweight infants and this category accounts for most cases of newborn death. Low-birthweight infants can be separated into two groups: preterm and small-for-date [24, 6]. Very-low-birthweight infants weigh less than 2¼ lb. An infant can also be included in the very-low-birthweight category if they have been in the womb less than 30 weeks before delivery. A large number of low and very-low-birthweight infant births remain unexplained; however, risk factors for delivering a low or very-low birthweight baby include an immature reproductive system of the mother, poverty, women who become pregnant within 6 months of a previous delivery, poor nutrition, a lack of medical care, and other medical conditions that may impact the pregnancy [4]. These are risk factors of respiratory and neurological abnormalities [7].

Preterm and small-for-date infants: Preterm infants are those born several weeks or more before their due date. Although they are small, their weight may still be appropriate for the amount of time spent in the womb. Small-for-date infants are infants below their expected weight considering the length of the pregnancy. Small-for-date infants typically experience more serious problems than preterm infants. Research suggests small-for-fate infants have difficulties with illness, cognitive functioning, and attention through childhood [13].

Postmaturity: Babies who have not been delivered 2 weeks after the mother’s due date, or 42 weeks after the last menstrual period are considered postmature. Toward the end of gestation, postmature babies receive insufficient blood supply and less oxygen than normal. Due to the labor complications that the large size of postmature babies poses as well as the heightened risk of postmature fetus brain damage or death, labor may be induced or the baby may be delivered by caesarean. Very often mothers with diabetes may have this problem [6].

Stillbirth: A stillbirth occurs when a fetus has died in the uterus, during labor, or delivery. The death of a fetus can be diagnosed during any of these periods although the causes of stillbirths are largely unknown. Electric fetal monitoring, ultrasound, and other observational methods likely have contributed to the decline in third-trimester stillbirths in the past 2 decades [6].

Infant mortality: Infant mortality, or death within the first year of life, is approximately 7 deaths for every 1,000 live births in the United States. The rate of infant survival is influenced by problems that can occur prenatally as well as difficulties that may occur during labor and delivery. Racial differences can be found in rates of infant mortality that are likely due to socioeconomic factors. Infant mortality rates in the United States have been associated with the high incidence of low-birthweight and preterm deliveries, poverty, and a lack of national health-care insurance [4] or policies that reduces access to services providing prenatal care.

Copyright information

© Springer Science+Business Media, LLC 2011
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