Routine Complications During Pregnancy, Birth, and Postpartum
At Roots Community Birth Center, we work with families who are having a low-risk pregnancy and planning to give birth at our birth center. As midwives, we view pregnancy and birth as normal and natural life events. Like all life events, pregnancy and birth come with their own unique circumstances and story, and we aim to prepare our clients for the vast range of normal birth events.
Part of that education is understanding that unexpected complications can occur during the prenatal period, while you’re in labor, or immediately after your baby is born. These complications require additional management from our midwives or other care providers in our community. At Roots, we are experienced in helping you work through these situations that arise, and our goal is always a healthy and safe outcome for you and baby.
How do we define a low-risk pregnancy, and what are the most common complications? In this blog, we’ll answer these questions and more!
What Does it Mean to Have a Low-Risk Pregnancy?
Low-risk is defined as someone having a single baby (no twins, triplets, or more); someone who gives birth between 37-42 weeks’ gestation; someone who has a head-down baby at the time of delivery; and someone who does not have hypertension or medication-managed gestational diabetes.
As midwives, our prenatal care and birth services continually assess risk factors, ensuring that our families are staying within our risk profile. This low-risk risk profile does mean we have the fortune of seeing relatively few labor and birth complications. However, the midwives are consistently monitoring both the birthing person and the baby, keeping an eye out for any pink flags so that the birth team can make an informed decision prior to any big red flags.
What Are the Most Common Complications That Happen During Pregnancy?
During pregnancy, the three most common scenarios that we see are gestational diabetes, high blood pressure, and a baby who is not in a head-down position. Let’s explore each of these complications and what they mean for your reproductive journey.
Gestational Diabetes
Gestational diabetes mellitus (GDM) is a temporary condition that can affect some pregnant people. According to the CDC, “Gestational diabetes occurs when your body can’t make enough insulin during your pregnancy. Insulin is a hormone made by your pancreas that acts like a key to let blood sugar into the cells in your body for use as energy.” If left unmanaged, gestational diabetes can result in a large birth weight for the baby, which may complicate delivery; the baby being born too early; or low blood sugar for the baby after birth.
We recommend a one-hour glucose screening to test the amount of glucose in your blood between 24 and 28 weeks of pregnancy. If the results show a high blood sugar level, a three-hour test to confirm gestational diabetes is usually the next step. A diagnosis of gestational diabetes does not necessarily mean you are high-risk. Our team will work with you to carefully monitor your condition.
Most folks with gestational diabetes can manage the condition without medication. At Roots, gestational diabetes that is well controlled with dietary and exercise changes does not risk a family out of the birth center. However, medication-managed GDM does necessitate a planned hospital birth.
High Blood Pressure
During your routine care visits with our midwives, we will take your blood pressure. Normal blood pressure, according to the American Heart Association, is 120/80 (or below) for pregnant people, the same as when you are not pregnant. An increase in blood pressure to 140/90 and above after 20 weeks’ gestation can indicate serious complications for you and your baby. These include preeclampsia, low birth weight, premature birth, or even stillbirth.
We take high blood pressure seriously, but we understand that pressure levels can fluctuate. If your blood pressure is high at the beginning of an appointment, we will take it again later during your visit and monitor you closely as your pregnancy progresses. If the high blood pressure, often called hypertension, persists during the second half of pregnancy, a planned hospital birth will be necessary to ensure the healthiest outcome for you and your baby.
Breech Baby
Most babies settle into a head-down position during the last few weeks of pregnancy. Other babies, however, do not turn in time and are breech, with their feet or bottom down and their head under your ribs. (Babies can also be in a transverse position, which is when they are lying horizontally across the uterus, rather than vertically. This position is quite rare, though.)
If your baby is breech during the last month of pregnancy, this increases your risk for having a complicated labor and birth. However, there are some methods and techniques that can encourage a breech baby to flip.
Chiropractic care: The Webster Technique, in particular, is an adjustment that improves alignment of the pelvic bones as they connect to the spine. This body work promotes optimal positioning of the baby, meaning it’s a safe, gentle, and effective way to encourage a breech baby to turn.
Spinning Babies: This valuable resource offers techniques and exercise that can encourage a breech baby to flip. For example, forward-leaning inversion and side-lying release are often helpful positions.
External cephalic version: This procedure is performed by an obstetrician to turn the baby into a head-down position. It’s usually considered after 36 weeks, and the provider uses ultrasound to guide the turning.
If your baby persists in being breech, a planned hospital birth is necessary.
With any of these three prenatal complications, your Roots midwives are prepared and happy to help you navigate the shifting of your plans, and to then welcome you and your baby back for postpartum and newborn care should you be interested.
What Are Possible Routine Complications During Birth?
Here are some complications that may arise during birth or in the immediate postpartum period.
Shoulder dystocia is a birth injury that occurs when one or both of a baby’s shoulders get stuck inside the birthing parent’s pelvis during labor.
A baby who requires some help taking their first breath may need suction or oxygen in the moments following birth.
A postpartum hemorrhage, or bleeding too much with the placenta delivery, may need special attention such as injections or IV medicines from our experienced midwives.
The Roots midwives are skilled and well trained in handling all three of these scenarios, and the birth center carries all the necessary oxygen, resuscitation equipment, medications, and IV supplies.
The vast majority of these complications are quickly and calmly resolved, and we do not leave the birth center. In the rare event that a complication does not resolve with the tools we have here at Roots, we would transfer via ambulance to North Memorial Hospital, where we have an excellent working relationship with the OB staff.
Takeaways About Routine Birth Complications
We highly encourage expecting parents to take our childbirth education series that includes a dedicated complications class. Our midwives are also happy to answer questions regarding complications, transfers, and more during your prenatal appointments and at your birthing time.
Do you have questions or concerns about risk, pregnancy, and giving birth at Roots? Please contact us. You can set up a free consultation by calling us at 612-338-2784 or filling out our form!