Pregnancy and childbirth are usually safe, healthy processes, but complications can occur. Early and ongoing prenatal care helps address potential problems before they become serious. Women who have certain chronic diseases have better chances of successful pregnancies if their illness is under control before pregnancy occurs. Listed below are the potential risks of pregnancy and childbirth.
Potential Risks
Ectopic pregnancy occurs when an embryo implants anywhere other than the uterus, most often the fallopian tube. The incidence is about 1 to 2% of all pregnancies. Ectopic pregnancy can be life-threatening and can cause internal damage and tubal rupture.
About 6 to 8% of pregnant women will develop hypertension during pregnancy. It is a life-threatening condition for mother and child.
About 4 to 9% of pregnant women will develop gestational diabetes, which increases the risk of hypertension during pregnancy as well as chances of a more difficult delivery.
A miscarriage (sometimes referred to as a spontaneous abortion) happens when, for various reasons, a woman’s body cannot support the pregnancy or there is a problem with growth and development that causes the pregnancy to end on its own. If the uterus does not empty itself completely, a medical or surgical procedure may be required to remove the tissues. Dilation and curettage (D&C) is a surgical procedure that can be used to remove remaining tissue. A local anesthetic will be used to numb the cervix. The procedure involves a cervical dilation after which the uterus will be scraped with a curved curette. A D&C procedure usually takes five to 10 minutes. Because most patients who undergo a D&C are given general anesthesia (medicine to put you to sleep), recovery time is about 24 hours. In certain situations, other forms of anesthesia can be used.
About 12% of pregnancies will result in premature delivery (between 20- and 37-weeks gestation). It is a leading cause of infant disability and/or death.
A Cesarean birth is the delivery of a baby through incisions made in the mother’s abdomen and uterus. A C-section may be needed for various reasons, including multiple pregnancy (twins), failure of labor to progress, breech presentation, and other medical conditions. Risks include infection, blood loss, blood clots, injury to the bowel or bladder and reaction to anesthesia.
Infection in the genital tract for any reason is associated with future fertility problems. It can cause internal damage if untreated. In some cases, antibiotics may be given during labor and delivery to prevent infection or will be prescribed if symptoms develop after delivery. It is estimated to occur in 1 to 6% of vaginal deliveries and a considerably higher percentage of Cesarean deliveries.
Occasionally, fragments of placenta remain in the uterus after delivery (.5% to 3% of deliveries). Heavy or irregular bleeding and infection may result. This may require an aspiration or dilation and curettage (D&C) to empty the uterus
Hemorrhage is heavy bleeding that can happen during or after labor. Some bleeding will be expected with all deliveries, but heavy bleeding is not normal and is not common. If it occurs, aspiration or medications may be used to treat it. It is estimated to occur in 4 to 5% of deliveries. Surgery or blood transfusion is rare
Lacerations to the genital tract, or injury to the bladder or rectum can occur during delivery. Damage can range from a self-healing surface cut to a deep tear requiring stitches or surgery. Uterine rupture is a rare complication of pregnancy
Any medication carries a risk of an allergic or adverse reaction. There are many medications that may be requested or prescribed during childbirth. Depending on the medication, risks and side effects may include a change in blood pressure, a change in the mother’s or unborn child’s heartbeat, trouble breathing, trouble pushing during delivery, dizziness, drowsiness, nausea, hemorrhage, headache and back pain. Seizures, uterine rupture and serious allergic reactions are rare.
Because every woman is different, each woman will experience childbirth differently. Feelings can range from intense joy to disappointment and sadness. It is common for women to experience a few days of the “baby blues” after delivery as the body and mind naturally adjust. Age, religion, financial situation, support network and past coping experiences can all affect how a woman adapts to motherhood. Women who feel they are having trouble functioning in their new role should know they are not alone and should contact their health care provider for help, especially if the feelings last more than two or three weeks or are extreme. Postpartum depression can interfere with a woman’s ability to care for herself and her child, and it is a fairly common and treatable disorder (occurring in 15 to 30% of new mothers).
The risk of death during childbirth is about 12 per 100,000.
The Impact of Tobacco and Secondhand Exposure
Many chemicals in commercial tobacco and alternative nicotine products are toxic to fetal development and respiratory, cardiac, and reproductive systems. Cigarette smoke contains more than 7,000 chemicals, and more than 70 can cause cancer. Smokeless tobacco contains at least 28 chemicals found to cause cancer. Other commercial tobacco products, such as electronic nicotine devices (vape) or alternative nicotine products, have harmful and addictive ingredients. Chemicals in commercial tobacco products enter the bloodstream, reducing the blood supply and oxygen to the womb necessary for normal growth and development and interfere with the body’s ability to absorb nutrients that a woman and developing child need. Commercial tobacco use during pregnancy increases the risk of pregnancy complications for the mother and affects the baby’s health before and after birth.
- Using tobacco products doubles the mom’s risk of abnormal bleeding during pregnancy and delivery. This can put both mom and baby in danger.
- The baby may be born too small, even after a full-term pregnancy. Commercial Tobacco use slows a baby’s growth before birth.
- The baby may be born too early (premature birth). Premature babies often have health problems.
- Using tobacco products can damage the baby’s developing lungs and brain. The damage can last through childhood and into the teen years.
- Using tobacco products raises a baby’s risk for congenital disabilities, including cleft lip, cleft palate, or both. A cleft is an opening in a baby’s lip or the roof of their mouth (palate). The baby can have trouble eating properly and is likely to need surgery.
- Babies of moms who smoke during pregnancy and those exposed to cigarette smoke after birth have a higher risk for Sudden Unexplained Infant Death (SUID).
There is no safe level of secondhand exposure. Secondhand smoke is a mixture of gases and particles from the burning end of a cigarette, cigar, or pipe and the smoke exhaled by smokers. Secondhand aerosol from vape devices contains nicotine, ultrafine particles, and low levels of toxins known to cause cancer.
What Can You Do to Protect Your Child?
- Never smoke, chew, or vape around your child. If you smoke, chew or vape, get help with quitting. Being tobacco-free reduces the chances your child will use tobacco products.
- Don’t allow anyone to use tobacco products in your home or around your child, including family members and babysitters. People moving to another room or opening a window to smoke or vape does not protect children from secondhand exposure.
- Don’t take your child to public places where people smoke, chew or vape. Keep liquid nicotine and vape devices locked up, out of sight, and out of reach. The products come in bright colors, various shapes, and appealing flavors and scents, making them attractive to young children. Nicotine is an acute toxin and can be harmful if swallowed or absorbed through the skin.
Where to Go for Help Quitting?
NDQuits provides free phone counseling and web support to all North Dakotans who want to quit commercial tobacco and alternative nicotine products. Free nicotine replacement therapy (nicotine patches, gum, or lozenges) is available to qualified enrollees; qualified enrollees are uninsured or underinsured (have insurance without cessation medication coverage).
Developing a quit plan and receiving coaching and cessation medication doubles your recovery success. For help beginning your quit journey, contact NDQuits by calling 1- 800-QUIT-NOW (1-800-784-8669) or visiting hhs.nd.gov/ndquits.