Common signs of childbirth-related complications

Childbirth is a wonderful experience that brings joy and fulfilment to both the mother and her family. Childbirth-related complications though often put a damper on this milestone.

Complications range from mild to severe. In chronic cases, the mother may even die. The World Health Organisation (WHO) estimates that 529,000 maternal deaths occur every year due to childbirth-related complications.

The most common after-birth complications include postpartum uterine infections, excessive bleeding, vaginal discharge, incontinence and postpartum depression.

HAEMORRHAGE

Excessive bleeding or haemorrhage after childbirth is the third biggest cause of maternal mortality in both developing and developed countries according to the World Health Organisation (WHO).

It occurs when the uterus fails to contract as it should after the placenta has been discharged.

WHO warns that haemorrhage could kill a healthy mother within two hours if not attended to. Excessive bleeding occurs in only two percent of all births.
Perineal pain: Perineum is the location between the vagina and the rectum. The soft muscles of this area may become swollen, tender or sore if they are bruised or stretched too much during delivery.
Uterine infection: This occurs if pieces of the placenta remain in the uterus (retained placenta) after childbirth.

In normal situations, it takes 20 minutes for the placenta to be discharged after delivery.

HIGH FEVER
Flu-like symptoms characterised by high fever, rapid heart rate, swollen and tender uterus and smelly discharge are indicators of uterine infection.
Uterine infection is treated using intravenous antibiotics.

Postpartum ‘baby blues’: After childbirth, women may experience mood swings, fear, anxiety, lack of sleep and crying spells. This occurs as the body and mind adjust to the arrival of the baby, and often phases out after two to three weeks.

Postpartum depression: This is a more severe psychological condition experienced by some new mothers.

Symptoms include extreme irritability, anger, hopelessness, severe anxiety and sleeplessness and suicidal thoughts. Loss of appetite and weight loss or weight gain may also manifest.

Treatment methods include therapies, medication (antidepressants) and self-care. If left untreated, postpartum depression could last for months.
DEPRESSION
Paternal postnatal depression (PPND): This occurs in men, and is the equivalent of postpartum depression in women.
It manifests through depression, anxiety, occasional mood swings and sleeplessness.

Common triggers of PPND are economic stresses such as inadequate resources, differences with the partner and lack of support from family and friends. PPND is common among first-time fathers, and could last for a whole year.
Counselling is recommended for fathers experiencing PPND.
Kidney infection: This occurs if bacteria spread to the kidney from the bladder during delivery.

Increased frequency of urination, high fever, feeling sickly, lower back pain, constipation and painful urination are all pointers of kidney infection.
Oral and intravenous antibiotics are used to treat this form of complication. Large volumes of fluids are also recommended to patients.

Faecal/bowel incontinence: This refers to the lack of ability to control defaecation.

INJURY

This complication is caused by damage or injury to the anal sphincter during delivery and occurs in five percent of women who undergo vaginal delivery.
It also results when the pelvic muscles are stretched and weakened or the perineum is torn, which affects bowel control.
Faecal incontinence lasts for several months.
Urinary incontinence: This is the involuntary passing of urine while laughing, coughing or straining.

It is caused by the stretching of the base of the bladder during delivery.

Urinary and faecal incontinence are treated by eating a balanced diet, performing pelvic floor exercises, using a bowel habit training programme and sometimes medication.

HAIRLOSS
Postpartum hair loss: This is hair loss that occurs about three months after childbirth.
Hormonal changes during pregnancy stimulate unusual growth of hair in expectant mothers.

After childbirth and as the body adjusts to the normal hormonal range, this hair, which will have grown fully, starts to fall off.

This type of air loss is normal, unrelated to breastfeeding, contrary to popular belief, and could last for between six months and one year.

Using hair texturiser, good quality shampoo and conditioners are common remedies for postpartum hair loss. Mothers are advised to avoid suing combs that stress or pull off hair.
Haemorrhoids and constipation: These may be worse by the pressure of the enlarged uterus and the foetus on the lower abdomen veins, leading to bleeding. About one in four women are constipated after delivery.

A diet rich in fibre, intake of fluids and using certain sprays and ointments all help to ease the effects of constipation and development of haemorrhoids.

Warning signs of most childbirth complications include chest pain, difficulty in breathing, heavy bleeding, severe headache, rashes, coughing and smelly vaginal discharge. Mothers are advised to consult a doctor if they experience these signs.