Editing Childbirth (section)

===Fetal complications===
[[File:Bumm 84 lg.jpg|thumb|Mechanical fetal injury may be caused by improper rotation of the fetus.]]
Five causes make up about 80% of newborn deaths globally: [[Preterm birth|prematurity]], [[Low birth weight|low-birth-weight]], infections, [[Perinatal asphyxia|lack of oxygen at birth]], and [[Birth trauma (physical)|trauma during birth]].<ref name=WHO2018New/>

====Stillbirth====
{{Main|Stillbirth}}
Stillbirth is typically defined as [[fetus|fetal]] death at or after 20 to 28 weeks of pregnancy.<ref name=NIH2014Def>{{cite web|title=Stillbirth: Overview|url=https://www.nichd.nih.gov/health/topics/stillbirth/Pages/default.aspx|website=NICHD|access-date=4 October 2016|date=23 September 2014|url-status=live|archive-url=https://web.archive.org/web/20161005085055/https://www.nichd.nih.gov/health/topics/stillbirth/Pages/default.aspx|archive-date=5 October 2016}}</ref><ref name="WHO2016">{{Cite web |title=Stillbirths |url=https://www.who.int/maternal_child_adolescent/epidemiology/stillbirth/en/ |url-status=dead |archive-url=https://web.archive.org/web/20161002035346/http://www.who.int/maternal_child_adolescent/epidemiology/stillbirth/en/ |archive-date=2 October 2016 |access-date=29 September 2016 |website=World Health Organization |language=en-GB}}</ref> It results in a baby born without [[vital signs|signs of life]].<ref name=WHO2016/>

Worldwide prevention of most stillbirths is possible with improved health systems.<ref name=WHO2016/><ref name=Lancet2016>{{cite journal|title=Ending preventable stillbirths An Executive Summary for The Lancet's Series|journal=The Lancet|date=Jan 2016|url=http://www.thelancet.com/pb/assets/raw/Lancet/stories/series/stillbirths2016-exec-summ.pdf|access-date=31 January 2020|archive-url=https://web.archive.org/web/20180712154237/http://www.thelancet.com/pb/assets/raw/Lancet/stories/series/stillbirths2016-exec-summ.pdf|archive-date=12 July 2018|url-status=dead}}</ref> About half of stillbirths occur during childbirth, and stillbirth is more common in the [[developing world|developing]] than [[developed world]].<ref name=WHO2016/> Otherwise depending on how far along the pregnancy is, [[induction of labor|medications may be used to start labour]] or a type of surgery known as [[dilation and evacuation]] may be carried out.<ref name=NIH2014Tx>{{cite web|title=How do health care providers manage stillbirth?|url=https://www.nichd.nih.gov/health/topics/stillbirth/topicinfo/Pages/managed.aspx|website=NICHD|access-date=4 October 2016|date=23 September 2014|url-status=live|archive-url=https://web.archive.org/web/20161005133645/https://www.nichd.nih.gov/health/topics/stillbirth/topicinfo/Pages/managed.aspx|archive-date=5 October 2016}}</ref> Following a stillbirth, women are at higher risk of another one; however, most subsequent pregnancies do not have similar problems.<ref>{{cite web|title=Stillbirth: Other FAQs|url=https://www.nichd.nih.gov/health/topics/stillbirth/topicinfo/Pages/questions.aspx|website=NICHD|access-date=4 October 2016|date=23 September 2014|url-status=live|archive-url=https://web.archive.org/web/20161005133552/https://www.nichd.nih.gov/health/topics/stillbirth/topicinfo/Pages/questions.aspx|archive-date=5 October 2016}}</ref>

Worldwide in 2019 there were about 2 million stillbirths that occurred after 28 weeks of pregnancy, this equates to 1 in 72 total births or one every 16 seconds.<ref>{{Cite web |title=Stillbirths and stillbirth rates |url=https://data.unicef.org/topic/child-survival/stillbirths/ |access-date=24 June 2022 |website=UNICEF DATA |language=en-US |archive-date=9 September 2021 |archive-url=https://web.archive.org/web/20210909023831/https://data.unicef.org/topic/child-survival/stillbirths/ |url-status=live }}</ref> Still births are more common in [[South Asia]] and [[Sub-Saharan Africa]].<ref name=WHO2016/> Stillbirth rates have declined, though more slowly since the 2000s.<ref name=Dra2016>{{Cite journal|last1=Draper|first1=Elizabeth S.|last2=Manktelow|first2=Bradley N.|last3=Smith|first3=Lucy|last4=Rubayet|first4=Sayed|last5=Hirst|first5=Jane|last6=Neuman|first6=Melissa|last7=King|first7=Carina|last8=Osrin|first8=David|last9=Prost|first9=Audrey|date=6 February 2016|title=Stillbirths: rates, risk factors, and acceleration towards 2030|journal=The Lancet|language=en|volume=387|issue=10018|pages=587–603|doi=10.1016/S0140-6736(15)00837-5|issn=0140-6736|pmid=26794078|doi-access=free}}</ref>

====Preterm birth====
{{Main|Preterm birth}}
Preterm birth is the birth of an infant at fewer than 37 weeks [[Gestational age (obstetrics)|gestational age]]. Globally, about 15 million infants were born [[preterm|before 37 weeks of gestation]].<ref>{{cite web |date=November 2015 |title=Preterm birth Fact sheet N°363 |url=https://www.who.int/mediacentre/factsheets/fs363/en/ |url-status=live |archive-url=https://web.archive.org/web/20150307050438/http://www.who.int/mediacentre/factsheets/fs363/en/ |archive-date=7 March 2015 |access-date=30 July 2016 |website=WHO}}</ref> Premature birth is the leading cause of death in children under five years of age though many that survive experience disabilities including learning defects and visual and hearing problems. Causes for early birth may be unknown or may be related to certain chronic conditions such as diabetes, infections, and other known causes.  The World Health Organization has developed guidelines with recommendations to improve the chances of survival and health outcomes for preterm infants.<ref>{{cite web|title=Preterm Birth|url=https://www.who.int/en/news-room/fact-sheets/detail/preterm-birth|website=World Health Organization|access-date=26 April 2018|archive-date=7 March 2015|archive-url=https://web.archive.org/web/20150307050438/http://www.who.int/mediacentre/factsheets/fs363/en/|url-status=live}}</ref><ref name=":15">{{Cite journal |last1=Tsatsaris |first1=Vassilis |last2=Cabrol |first2=Dominique |last3=Carbonne |first3=Bruno |date=2004 |title=Pharmacokinetics of tocolytic agents |url=https://pubmed.ncbi.nlm.nih.gov/15509182 |journal=Clinical Pharmacokinetics |volume=43 |issue=13 |pages=833–844 |doi=10.2165/00003088-200443130-00001 |issn=0312-5963 |pmid=15509182 |s2cid=43377674 |access-date=12 September 2022 |archive-date=12 September 2022 |archive-url=https://web.archive.org/web/20220912174616/https://pubmed.ncbi.nlm.nih.gov/15509182/ |url-status=live }}</ref>

If a pregnant woman enters preterm labour, delivery can be delayed by giving medications called [[tocolytics]]. Tocolytics delay labour by inhibiting contractions of the uterine muscles that progress labour. The most widely used tocolytics include beta agonists, calcium channel blockers, and magnesium sulfate. The goal of administering tocolytics is not to delay delivery to the point that the child can be delivered at term, but instead to postponing delivery long enough for the administration of [[glucocorticoids]] which can help the fetal lungs to mature enough to reduce morbidity and mortality from [[Hyaline membrane disease|infant respiratory distress syndrome]].<ref name=":15" />

==== Post-term birth ====
{{Main|Postterm pregnancy}}
The term postterm pregnancy is used to describe a condition in which a woman has not yet delivered her baby after 42 weeks of [[gestation]], two weeks beyond the usual 40-week duration of pregnancy.<ref>{{cite web |url=http://www.merck.com/mmpe/sec19/ch272/ch272f.html |title=Postmature Infant |access-date=6 October 2008 |last=Kendig |first=James W |date=March 2007 |work=The Merck Manuals Online Medical Library |archive-date=20 August 2012 |archive-url=https://web.archive.org/web/20120820014059/http://www.merckmanuals.com/professional/sec19/ch272/ch272f.html |url-status=live }}</ref> Postmature births carry risks for both the mother and the baby, including [[meconium aspiration syndrome]], fetal malnutrition, and [[stillbirths]].<ref>{{cite journal |last1=Muglu |first1=J |last2=Rather |first2=H |last3=Arroyo-Manzano |first3=D |last4=Bhattacharya |first4=S |last5=Balchin |first5=I |last6=Khalil |first6=A |last7=Thilaganathan |first7=B |last8=Khan |first8=KS |last9=Zamora |first9=J |last10=Thangaratinam |first10=S |title=Risks of stillbirth and neonatal death with advancing gestation at term: A systematic review and meta-analysis of cohort studies of 15 million pregnancies. |journal=PLOS Medicine |date=July 2019 |volume=16 |issue=7 |pages=e1002838 |doi=10.1371/journal.pmed.1002838 |pmid=31265456|pmc=6605635 |doi-access=free }}</ref> The [[placenta]], which supplies the baby with oxygen and nutrients, begins to age and will eventually fail after the 42nd week of gestation. Induced labour is indicated for postterm pregnancy.<ref name=":03">{{Cite journal |date=August 2014 |title=Practice Bulletin No. 146: Management of Late-Term and Postterm Pregnancies |url=https://journals.lww.com/greenjournal/Abstract/2014/08000/Practice_Bulletin_No__146__Management_of_Late_Term.34.aspx |journal=Obstetrics & Gynecology |language=en-US |volume=124 |issue=2 PART 1 |pages=390–396 |doi=10.1097/01.AOG.0000452744.06088.48 |pmid=25050770 |s2cid=7149045 |issn=0029-7844 |access-date=12 September 2022 |archive-date=11 September 2022 |archive-url=https://web.archive.org/web/20220911182548/https://journals.lww.com/greenjournal/Abstract/2014/08000/Practice_Bulletin_No__146__Management_of_Late_Term.34.aspx |url-status=live }}</ref><ref name=":16">{{Cite journal |last=Neff |first=Matthew J. |date=1 December 2004 |title=ACOG Releases Guidelines on Management of Post-term Pregnancy |url=https://www.aafp.org/pubs/afp/issues/2004/1201/p2221.html |journal=American Family Physician |language=en-US |volume=70 |issue=11 |pages=2221–2225 |access-date=12 September 2022 |archive-date=11 September 2022 |archive-url=https://web.archive.org/web/20220911182540/https://www.aafp.org/pubs/afp/issues/2004/1201/p2221.html |url-status=live }}</ref><ref>{{Cite journal |last1=Wang |first1=Mary |last2=Fontaine |first2=Patricia |date=1 August 2014 |title=Common Questions About Late-Term and Postterm Pregnancy |url=https://www.aafp.org/pubs/afp/issues/2014/0801/p160.html |journal=American Family Physician |language=en-US |volume=90 |issue=3 |pages=160–165 |pmid=25077721 |access-date=12 September 2022 |archive-date=11 September 2022 |archive-url=https://web.archive.org/web/20220911182537/https://www.aafp.org/pubs/afp/issues/2014/0801/p160.html |url-status=live }}</ref>

====Neonatal infection====
{{Main|Neonatal infection}}
[[File:Neonatal infections and other (perinatal) conditions world map - DALY - WHO2004.svg|thumb|[[Disability-adjusted life year]] for neonatal infections and other (perinatal) conditions per 100,000&nbsp;inhabitants in 2004. Excludes [[preterm birth|prematurity]] and low birth weight, [[birth asphyxia]] and [[birth trauma (physical)|birth trauma]] which have their own maps/data.<ref>{{cite web |title= Mortality and Burden of Disease Estimates for WHO Member States in 2004 |url= https://www.who.int/entity/healthinfo/global_burden_disease/gbddeathdalycountryestimates2004.xls |format= xls |publisher= Department of Measurement and Health Information, World Health Organization |date= February 2009 |access-date= 4 October 2020 |archive-date= 28 August 2021 |archive-url= https://web.archive.org/web/20210828123901/https://www.who.int/healthinfo/global_burden_disease/gbddeathdalycountryestimates2004.xls |url-status= live }}</ref>{{Div col|small=yes|colwidth=10em}}
{{legend|#b3b3b3|no data}}
{{legend|#ffff65|less than 150}}
{{legend|#fff200|150–300}}
{{legend|#ffdc00|300–450}}
{{legend|#ffc600|450–600}}
{{legend|#ffb000|600–750}}
{{legend|#ff9a00|750–900}}
{{legend|#ff8400|900–1050}}
{{legend|#ff6e00|1050–1200}}
{{legend|#ff5800|1200–1350}}
{{legend|#ff4200|1350–1500}}
{{legend|#ff2c00|1500–1850}}
{{legend|#cb0000|more than 1850}}
{{div col end}}]]

Newborns are prone to infection in the first month of life. The [[pathogenic bacterium]] ''[[Streptococcus agalactiae]]'' (a group B streptococcus) is most often the cause of these occasionally fatal infections. The baby contracts the infection [[Vertical transmission|from the mother]] during labour. In 2014 it was estimated that about one in 2000 newborn babies had a group B streptococcuss infection within the first week of life, usually evident as [[respiratory disease]], general [[sepsis]], or [[meningitis]].<ref>{{cite journal | vauthors = Ohlsson A, Shah VS | title = Intrapartum antibiotics for known maternal Group B streptococcal colonization | journal = The Cochrane Database of Systematic Reviews | issue = 6 | pages = CD007467 | date = June 2014 | volume = 2016 | pmid = 24915629 | doi = 10.1002/14651858.CD007467.pub4 | s2cid = 205189572 }}</ref>

Untreated [[sexually transmitted infections]] (STIs) are associated with [[birth defect]]s, and infections in newborn babies, particularly in the areas where rates of infection remain high. The majority of STIs have no symptoms or only mild symptoms that may not be recognised.  Mortality rates resulting from some infections may be high, for example the overall perinatal mortality rate associated with untreated syphilis is 30%.<ref name="WHO-STI">{{cite web |title= Sexually transmitted infections (STIs) |url=https://www.who.int/mediacentre/factsheets/fs110/en/ |volume= Fact sheet 110 |date= May 2013 |access-date= 30 August 2013 |publisher= World Health Organization |url-status= live |archive-url= https://web.archive.org/web/20141125133056/http://www.who.int/mediacentre/factsheets/fs110/en/ |archive-date= 25 November 2014 }}</ref>

====Perinatal asphyxia====
{{Main|Perinatal asphyxia}}

[[Perinatal asphyxia]] is the medical condition resulting from [[Hypoxia (medical)|deprivation of oxygen]] to a newborn infant that lasts long enough during the birth process to cause physical harm.<ref name="ReferenceA" /> Hypoxic damage can also occur to most of the infant's organs ([[heart]], [[lung]]s, [[liver]], [[Gut (zoology)|gut]], [[kidneys]]), but [[brain damage]] is of most concern and perhaps the least likely to quickly or completely heal.<ref name="ReferenceA">{{cite journal | vauthors = van Handel M, Swaab H, de Vries LS, Jongmans MJ | title = Long-term cognitive and behavioral consequences of neonatal encephalopathy following perinatal asphyxia: a review | journal = European Journal of Pediatrics | volume = 166 | issue = 7 | pages = 645–54 | date = July 2007 | pmid = 17426984 | pmc = 1914268 | doi = 10.1007/s00431-007-0437-8 }}</ref> Oxygen deprivation can lead to permanent disabilities in the child, such as [[cerebral palsy]].<ref>{{Citation |last1=Marret |first1=Stéphane |title=Chapter 16 - Pathophysiology of cerebral palsy |date=1 January 2013 |url=https://www.sciencedirect.com/science/article/pii/B9780444528919000166 |journal=Handbook of Clinical Neurology |volume=111 |pages=169–176 |editor-last=Dulac |editor-first=Olivier |series=Pediatric Neurology Part I |publisher=Elsevier |language=en |access-date=28 July 2022 |last2=Vanhulle |first2=Catherine |last3=Laquerriere |first3=Annie |doi=10.1016/B978-0-444-52891-9.00016-6 |pmid=23622161 |isbn=9780444528919 |editor2-last=Lassonde |editor2-first=Maryse |editor3-last=Sarnat |editor3-first=Harvey B.}}</ref>

====Mechanical fetal injury====
{{Main|Birth trauma (physical)}}
Risk factors for fetal birth injury include [[fetal macrosomia]] (big baby), [[maternal obesity]], the need for instrumental delivery, and an inexperienced attendant. Specific situations that can contribute to birth injury include breech presentation and [[shoulder dystocia]]. Most fetal birth injuries resolve without long term harm, but [[brachial plexus injury]] may lead to [[Erb's palsy]] or [[Klumpke's paralysis]].<ref name="GraysAnatomy35th1046">{{cite book| title=Gray's Anatomy | veditors = Warwick R, Williams PL | edition=35th British| publisher= Longman |location=London|year=1973 |page=1046 |isbn=978-0443010118 <!-- isbn for publication in Philadelphia by Saunders same edition, page not verified -->| title-link=Gray's Anatomy }}</ref>