For most women, the birth of a newborn baby proceeds without problems. However, a number of problems can arise, including premature birth, breech birth, cesarean section delivery, and stillbirth.
Premature Birth: The Hazards of Early Delivery
The majority of babies are born late rather than early. Birth that takes place before the 37th week of pregnancy is considered premature birth. About 8% of births in the United States are premature. Prematurity increases the risk of birth-related defects and infant mortality (Palca, 1991). However, research into pediatrics has led to tremendous improvements in the survival rates of premature infants. Today infants born at 24 weeks’ gestation have a greater than 50% chance of survival (Welty, 2005). Unfortunately, more than half of these infants who survive develop complications and long-term effects of prematurity, such as developmental difficulties.
Birth may occur prematurely for several reasons, including early labor or early rupture of the amniotic membranes or because of a maternal or fetal problem. It is common for women who have had one premature birth to have subsequent premature births. Approximately 50% of all twin births are premature, and delivery of multiple fetuses occurs about 3 weeks earlier, on average, than single births. In 2004 the world’s smallest surviving premature baby was born, weighing in at 8.6 ounces (her twin sister weighed 1 pound, 4 ounces; Huffstutter, 2004). These twins were delivered via caesarean section in the 26th week of pregnancy due to medical problems experienced by their mother. Other factors that may lead to premature birth include smoking during pregnancy, alcohol or drug use, inadequate weight gain or nutrition, heavy physical labor during the pregnancy, infections, and teenage pregnancy.
Figure 12.5
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In 3% to 4% of births, the fetus is in the breech position, with feet and buttocks against the cervix.
2002) . Many hospitals are working with physicians to decrease the number of cesarean births; so far, these programs have been successful. In the United States today, approximately 21% of babies are born by cesarean section.
C-sections are needed when the baby is too large for a woman to deliver vaginally, the woman is unable to push the baby out the birth canal, the placenta blocks the cervix (placenta previa), the cervix does not dilate to 10 centimeters, or the baby is in fetal distress. If a doctor decides that a cesarean is necessary, the woman is moved to an operating room and is given either a general anesthestic or an epidural. The operation usually lasts between 20 and 90 minutes, and the woman will likely stay in the hospital longer than those who deliver vaginally. Women who have c-section births can get pregnant again and, although a woman may be able to deliver her next baby vaginally after a c-section (this referred to as a VBAC, or “vaginal birth after cesarean”), some choose to have another c-section for a variety of reasons, including to avoid the pain of vaginal labor or the risk of uterine rupture.