72 Pregnancy and Childbir th
A woman who is likely
to have a dangerous
birth should plan
to have her baby in
a health center or
Women who have extra risks
Women with any of the following problems can have more
dangerous pregnancies and births. They should plan to go to
a health center or hospital for birth, and they may need more
prenatal care during pregnancy.
• Weak blood (anemia) makes a woman more likely to bleed
heavily (hemorrhage) during birth, become ill after childbirth,
or even die. For more on anemia, see the next page.
• Sugar sickness (diabetes) often causes very serious problems
for the mother and the baby. The baby can die before birth or
sometimes grows very large and gets stuck in the pelvis.
• High blood pressure can lead to severe headaches, seizures, and
• Older mothers who have had many babies often have long,
difficult labors, and heavy bleeding after the birth.
• Mothers under the age of 17 are more likely to have
eclampsia (seizures), long, difficult labors, babies born too early
(premature), and blocked births, which may damage the bladder,
vagina, and womb and can kill the mother (see page 370).
• Mothers who had problems with past pregnancies—such
as seizures, birth by operation, heavy bleeding, a too-early or
too-small baby, or a baby born dead—are more likely to have
problems in another pregnancy or birth.
• Women with disabilities, with a loss of feeling in the body or
difficulty walking, can have problems during both pregnancy
and birth (see page 145.)
• Women with HIV risk having HIV spread to their babies, but
can take medicines to prevent this (see page 520).
Other women who should try to give birth
at a health center or hospital
Some women—who have none of the extra risks listed above—are still likely to
have dangerous births.These women should also try to give birth at a health center
• A woman with a baby in the wrong position for birth at the end of pregnancy
(see page 75) may die without surgery. Some positions of the baby lead to
especially long and difficult labors.
• Women carrying twins often have one baby in the wrong position for birth. Also,
these mothers are more likely to bleed after birth.
• Women who have their genitals cut can have severe tearing of the genitals during
the birth (see page 464). This can cause great pain, heavy blood loss, and infection.
Where Women Have No Doctor 2012