Complications of Labor and Delivery

Despite a common misconception among the public, intrapartum events rarely lead to fetal injury. Neonatal encephalopathy and cerebral palsy can result from multiple pathways, and 70% of cases are believed to be secondary to events that occurred prior to the onset of labor. Moreover, the overall incidence of neonatal encephalopathy attributable to intrapartum hypoxia, in the absence of any other potential preconception or antepartum causes, is estimated to be approximately 1.6/10,000. Despite this, the practice of obstetrics has rapidly evolved as a reaction to both extrinsic and intrinsic factors. Today, cesarean section rates are at all-time highs, operative vaginal delivery rates are decreasing, and evidence-based obstetrics is threatened to be replaced by defensive, anecdotally based medicine.