When Labor Takes a Detour: Understanding Common Labor Complications

Labor is a journey—and like any great journey, it doesn’t always follow a perfect, predictable path. Even with all the planning and prep in the world, labor can still take unexpected turns. And that’s okay.

Complications during labor are common—and with the right care team and mindset, they’re usually very manageable. Understanding the possibilities ahead of time can help you feel more prepared and less overwhelmed if your birth story takes a different route than expected.

Let’s walk through some of the most common labor complications: what they are, how they’re usually detected, and what you can do if they happen.

1. Breech Presentation

A breech baby is positioned feet-first (or bottom-first), instead of head-down—the ideal position for a vaginal birth. By 37 weeks, about 3–4% of babies remain breech.

Some babies turn on their own, but if yours doesn’t, options like swimming, inversions, or acupuncture might help. Your provider may also recommend an external cephalic version (ECV)—a procedure to try turning the baby manually—or discuss a planned C-section.

Emotionally, this can bring up a lot. That’s normal. Take time to explore your options and lean on your provider and support people. Making informed choices helps you stay in the driver’s seat of your birth.

2. Induction of Labor

Induction means medically starting labor—and it’s common: around 30% of labors in the U.S. are induced.

Reasons for induction include going past your due date, health concerns for you or your baby, or sometimes maternal choice. Methods may include:

• Medications like Cytotec or Pitocin
  
• Breaking your water
  
• A balloon catheter to help open the cervix

Whether induction is a surprise or part of your plan, being flexible and asking questions will help you feel more confident and in control when the time comes.

3. Arrest of Dilation or Descent

Labor progression isn’t always linear. Sometimes the cervix stops opening (arrest of dilation) or the baby stops moving down the birth canal (arrest of descent). This occurs in roughly 8–10% of labors.

Your provider may notice a stall during cervical checks or pushing. Possible next steps include:

• Resting or changing positions
• Augmenting labor with Pitocin
• Discussing assisted delivery (vacuum or forceps)
• Considering a cesarean birth

If you hear things “aren’t progressing,” pause and take a breath. Truly. Creating a calm environment boosts oxytocin (the love hormone), reduces cortisol (stress), and helps your body work with you—not against you.

4. Fetal Malposition or Malpresentation

Sometimes babies find creative positions—like being "sunny-side up" (facing forward) or angled in the pelvis. This can lead to longer or more challenging labor and affects about 5–8% of births.

Signs might include:

• Pain in a specific area
• Slowed or stalled cervical dilation

To help baby shift, your care team may suggest:

• Labor positions that open the pelvis
• Hands-and-knees posture
• Manual rotation (if needed and safe)

Movement is powerful—even with an epidural. Trust that every shift, sway, and turn is helping your baby find their way.

5. Chorioamnionitis

This is an infection of the amniotic fluid and membranes around your baby, occurring in about 2–5% of labors.

Signs can include:

• Fever
• Elevated heart rates (for you or baby)
• Uterine tenderness

If chorioamnionitis is diagnosed, you’ll likely receive antibiotics, Tylenol, and a plan to move toward delivery. It can feel scary to hear the word “infection,” but treatment is effective—and fast action is key.

6. Fetal Distress

Labor is a journey for your baby, too. Occasionally, their heart rate may suggest they’re not tolerating labor well—this is called fetal distress, and it happens in 2–3% of births.

It’s usually detected through continuous monitoring (which your nurse is always watching). If distress appears, your team may:

• Help you change positions
• Give IV fluids or oxygen
• Recommend moving toward delivery sooner

It’s completely normal to feel anxious hearing that your baby’s heart rate is being monitored closely—but this is exactly why your care team is there: to notice subtle changes early and take action.

7. Perineal Tearing

During vaginal delivery, it’s very common for the skin and muscles between the vagina and anus (the perineum) to stretch—and sometimes tear. About 50–70% of first-time moms experience some degree of tearing.

Tears are usually minor and repaired right after birth, while you’re bonding with your baby. Your provider may also take preventive measures, such as:

• Perineal massage or oil
• Warm compresses during pushing
• Gentle delivery techniques

To support healing, use:

• Ice packs
• Peri bottle
• Sitz baths
• Witch hazel pads
• Rest and time

Many people also benefit from pelvic floor physical therapy before or after delivery.

Staying Calm When the Unexpected Happens

Labor is unpredictable—but it should always be centered around you and your baby. The goal is a safe, empowering experience, whether or not it follows your original plan.

A few ways to stay grounded:

• Choose a care team you trust
  
• Have a birth plan, but keep it flexible
• Ask questions so you understand your options
• Lean on your support people—they’re there for you!

At the end of the day, it’s your birth. With the right information and support, you can feel confident and calm—no matter what twists and turns your labor takes.