Editing Childbirth (section)

===Maternal complications===
{{Main|Puerperal disorder}}
A puerperal disorder or postpartum disorder is a complication which presents primarily during the puerperium, or postpartum period. The postpartum period can be divided into three distinct stages; the initial or acute phase, six to 12 hours after childbirth; subacute postpartum period, which lasts two to six weeks, and the delayed postpartum period, which can last up to six months.  In the subacute postpartum period, 87% to 94% of women report at least one health problem.<ref name="Glazener_1995">{{cite journal | vauthors = Glazener CM, Abdalla M, Stroud P, Naji S, Templeton A, Russell IT | title = Postnatal maternal morbidity: extent, causes, prevention and treatment | journal = British Journal of Obstetrics and Gynaecology | volume = 102 | issue = 4 | pages = 282–87 | date = April 1995 | pmid = 7612509 | doi = 10.1111/j.1471-0528.1995.tb09132.x | s2cid = 38872754 }}</ref><ref name="Thompson_2002">{{cite journal | vauthors = Thompson JF, Roberts CL, Currie M, Ellwood DA | title = Prevalence and persistence of health problems after childbirth: associations with parity and method of birth | journal = Birth | volume = 29 | issue = 2 | pages = 83–94 | date = June 2002 | pmid = 12051189 | doi = 10.1046/j.1523-536X.2002.00167.x }}</ref> Long-term health problems (persisting after the delayed postpartum period) are reported by 31% of women.<ref name="Borders_2006">{{cite journal | vauthors = Borders N | title = After the afterbirth: a critical review of postpartum health relative to method of delivery | journal = Journal of Midwifery & Women's Health | volume = 51 | issue = 4 | pages = 242–48 | date = 2006 | pmid = 16814217 | doi = 10.1016/j.jmwh.2005.10.014 }}</ref>

====Postpartum bleeding====

{{Main|Postpartum bleeding}}

Bleeding (haemorrhage) is the leading cause of maternal death worldwide accounting for approximately 27.1% of maternal deaths.<ref name=":8">{{Cite journal |last1=Say |first1=Lale |last2=Chou |first2=Doris |last3=Gemmill |first3=Alison |last4=Tunçalp |first4=Özge |last5=Moller |first5=Ann-Beth |last6=Daniels |first6=Jane |last7=Gülmezoglu |first7=A. Metin |last8=Temmerman |first8=Marleen |last9=Alkema |first9=Leontine |date=1 June 2014 |title=Global causes of maternal death: a WHO systematic analysis |journal=The Lancet Global Health |language=English |volume=2 |issue=6 |pages=e323–e333 |doi=10.1016/S2214-109X(14)70227-X |issn=2214-109X |pmid=25103301|s2cid=8706769 |doi-access=free |hdl=1854/LU-5796925 |hdl-access=free }}</ref> Within maternal deaths due to haemorrhage, two-thirds are caused by postpartum haemorrhage.<ref name=":8" /> The causes of [[Postpartum bleeding|postpartum haemorrhage]] can be separated into four main categories: tone, trauma, tissue, and thrombin. Tone represents [[uterine atony]], the failure of the uterus to contract adequately following delivery. Trauma includes lacerations or uterine rupture. Tissue includes conditions that can lead to a retained placenta. [[Thrombin]], which is a molecule used in the human body's blood clotting system, represents all coagulopathies.<ref>{{Cite journal |last1=Bienstock |first1=Jessica L. |last2=Eke |first2=Ahizechukwu C. |last3=Hueppchen |first3=Nancy A. |date=29 April 2021 |title=Postpartum Hemorrhage |journal=The New England Journal of Medicine |volume=384 |issue=17 |pages=1635–1645 |doi=10.1056/NEJMra1513247 |issn=1533-4406 |pmid=33913640 |pmc=10181876 |s2cid=233447661 }}</ref>

====Postpartum infections====
{{Main|Postpartum infections}}
[[Postpartum infections]], also historically known as childbed fever and medically as puerperal fever, are any bacterial infections of the reproductive tract following childbirth or miscarriage.  Signs and symptoms usually include a fever greater than 38.0&nbsp;°C (100.4&nbsp;°F), chills, lower abdominal pain, and possibly bad-smelling vaginal discharge.  The infection usually occurs after the first 24 hours and within the first ten days following delivery.  Infection remains a major cause of maternal deaths and morbidity in the [[Developing country|developing world]].<ref name="W2014">{{cite book |title=Williams Obstetrics |date=2014 |publisher=McGraw-Hill Professional |isbn=978-0-07-179893-8 |edition=24th |pages=Chapter 37 |chapter=37}}</ref>

====Psychological complications====
{{Main|Psychiatric disorders of childbirth|Postpartum psychosis|Postpartum depression|Childbirth-related posttraumatic stress disorder|Maternity blues}}

Childbirth can be an intense event and strong emotions, both positive and negative, can be brought to the surface. Abnormal and persistent fear of childbirth is known as [[tokophobia]]. The prevalence of fear of childbirth around the world ranges between 4–25%, with 3–7% of pregnant women having clinical fear of childbirth.<ref name="pmid26124521">{{cite journal | vauthors = Jaju S, Al Kharusi L, Gowri V | title = Antenatal prevalence of fear associated with childbirth and depressed mood in primigravid women | journal = Indian Journal of Psychiatry | volume = 57 | issue = 2 | pages = 158–61 | date = 2015 | pmid = 26124521 | pmc = 4462784 | doi = 10.4103/0019-5545.158152 | doi-access = free }}</ref><ref name="pmid25200969">{{cite journal | vauthors = Lukasse M, Schei B, Ryding EL | title = Prevalence and associated factors of fear of childbirth in six European countries | journal = Sexual & Reproductive Healthcare | volume = 5 | issue = 3 | pages = 99–106 | date = October 2014 | pmid = 25200969 | doi = 10.1016/j.srhc.2014.06.007 | hdl = 10642/2246 | hdl-access = free }}</ref>
Although pain may be seen as a self-evident and indisputable fact, in reality pain is only one sensation of childbirth. There are many other sensations such as bliss, joy and satisfaction which can be more powerful than pain. Negative expectations can actually increase sensitivity to pain through the process of [[nocebo]] [[hyperalgesia]]. At the same time positive expectations can reduce pain through [[placebo]] [[Pain management|analgesia]].<ref>{{cite journal |last1=Carlino |first1=Elisa |last2=Frisaldi |first2=Elisa |last3=Benedetti |first3=Fabrizio |title=Pain and the Context |journal=Nature Reviews Rheumatology |date=June 2014 |volume=10 |issue=6 |pages=348–355 |doi=10.1038/nrrheum.2014.17 |pmid=24567065 |url=https://rdcu.be/dFdFi}}</ref>

Most new mothers may experience mild feelings of unhappiness and worry after giving birth.  Babies require a lot of care, so it is normal for mothers to be worried about, or tired from, providing that care.  The feelings, often termed the [[Maternity blues|"baby blues"]], affect up to 80% of mothers.  They are somewhat mild, last a week or two, and usually go away on their own.<ref name="Postpartum Depression Facts">{{cite web|title=Postpartum Depression Facts|url=https://www.nimh.nih.gov/health/publications/postpartum-depression-facts/index.shtml|website=National Institute of Mental Health|access-date=4 May 2018|archive-date=21 June 2017|archive-url=https://web.archive.org/web/20170621200731/https://www.nimh.nih.gov/health/publications/postpartum-depression-facts/index.shtml|url-status=live}}</ref>

[[Postpartum depression]] is different from the "baby blues".  With postpartum depression, feelings of sadness and anxiety can be extreme and might interfere with a woman's ability to care for herself or her family. Because of the severity of the symptoms, postpartum depression usually requires treatment. The condition, which occurs in nearly 15% of births, may begin shortly before or any time after childbirth, but commonly begins between a week and a month after delivery.<ref name="Postpartum Depression Facts"/>

[[Childbirth-related post-traumatic stress disorder]] is a psychological disorder that can develop in women who have recently given birth.<ref>{{cite journal | vauthors = Lapp LK, Agbokou C, Peretti CS, Ferreri F | title = Management of post traumatic stress disorder after childbirth: a review | journal = Journal of Psychosomatic Obstetrics and Gynaecology | volume = 31 | issue = 3 | pages = 113–22 | date = September 2010 | pmid = 20653342 | doi = 10.3109/0167482X.2010.503330 | s2cid = 23594561 }}</ref><ref name=Condon2010>{{cite journal | vauthors = Condon J | title = Women's mental health: a "wish-list" for the DSM V | journal = Archives of Women's Mental Health | volume = 13 | issue = 1 | pages = 5–10 | date = February 2010 | pmid = 20127444 | doi = 10.1007/s00737-009-0114-1 | s2cid = 1102994 }}</ref><ref>{{cite book | last = Martin | first = Colin | name-list-style = vanc | title = Perinatal Mental Health: a Clinical Guide | publisher = M & K Pub | location = Cumbria England | year = 2012 | isbn = 978-1907830495 | page = 26}}</ref> Causes include issues such as an emergency C-section, preterm labour, inadequate care during labour,
lack of social support following childbirth, and others.  Examples of symptoms include [[intrusive thoughts|intrusive symptoms]], [[Flashback (psychology)|flashbacks]] and [[nightmare]]s, as well as symptoms of [[avoidance coping|avoidance]] (including [[amnesia]] for the whole or parts of the event), problems in developing a [[Maternal bond|mother-child attachment]], and others similar to those commonly experienced in [[posttraumatic stress disorder]] (PTSD).  Many women who are experiencing symptoms of PTSD after childbirth are misdiagnosed with postpartum depression or [[adjustment disorder]]s.  These diagnoses can lead to inadequate treatment.<ref name=Alder2006>{{cite journal | vauthors = Alder J, Stadlmayr W, Tschudin S, Bitzer J | title = Post-traumatic symptoms after childbirth: what should we offer? | journal = Journal of Psychosomatic Obstetrics and Gynaecology | volume = 27 | issue = 2 | pages = 107–12 | date = June 2006 | pmid = 16808085 | doi = 10.1080/01674820600714632 | s2cid = 21859634 }}</ref>

[[Postpartum psychosis]] is a rare [[Emergency psychiatry|psychiatric emergency]] in which symptoms of high mood and racing thoughts ([[mania]]), depression, severe confusion, loss of inhibition, paranoia, hallucinations and delusions set in, beginning suddenly in the first two weeks after childbirth. The symptoms vary and can change quickly.<ref name=LancetRev2014>{{cite journal | vauthors = Jones I, Chandra PS, Dazzan P, Howard LM | title = Bipolar disorder, affective psychosis, and schizophrenia in pregnancy and the post-partum period | journal = Lancet | volume = 384 | issue = 9956 | pages = 1789–99 | date = November 2014 | pmid = 25455249 | doi = 10.1016/S0140-6736(14)61278-2 | s2cid = 44481055 }}</ref> It usually requires hospitalisation. The most severe symptoms last from two to 12 weeks, and recovery takes six months to a year.<ref name=LancetRev2014/>