Hemorrhage, or excessive bleeding, can happen after a complicated birth. Often it results from failure of the uterus to contract after delivery. Normally, these contractions stop the bleeding that occurs once the placenta separates from the uterine wall. But complications or incomplete placental separation can lead to continued bleeding, and without rapid medical intervention, a woman can quickly bleed to death.

When skilled birth attendants are present, oxytocin can be given to prevent bleeding. If severe bleeding does occur, the mother is resuscitated and attendants apply methods ranging from further medication and manual pressure to stop the bleeding through to emergency surgery.

Severe infection can develop during pregnancy or from unhygienic conditions during delivery. One common type is reproductive tract infections (RTI), which cause intrauterine infections that can eventually be fatal to the woman. They can also cause life-threatening infection in the infant.

Access to clean water and hygienic conditions during delivery, such as clean hands and a clean delivery surface like a plastic cover, are vital to preventing infections. If an infection occurs, early detection and treatment with the appropriate antibiotic can prevent serious illness or death.

Eclampsia and other hypertensive disorders of pregnancy are linked to high blood pressure and are characterised by seizures that can lead to coma and death. Eclampsia begins during pregnancy as pre-eclampsia, which leads to high blood pressure. Without prenatal care pre-eclampsia can develop into severe pre-eclampsia or full eclampsia, causing symptoms such as swelling, sudden weight gain, headaches, changes in vision, and potentially fatal convulsions.

Unsafe abortion is a procedure for terminating an unwanted pregnancy either by persons lacking the necessary skills or in an environment lacking minimal medical standards, or both, as defined by the World Health Organization. MSF is dedicated to bringing safe abortion care to all women, especially in developing countries. 

Obstructed labor can occur if the baby’s head is too large or its position is abnormal, blocking passage through the birth canal. When a mother is malnourished or is very young and therefore has an underdeveloped pelvis, the birth canal itself is often not wide enough to accommodate the head of the baby. If an obstructed labour becomes prolonged, lasting more than 24 hours, the baby may die and the woman is at risk of postpartum hemorrhage, uterine rupture or fistula, and severe infection—all potentially fatal.

Skilled staff are essential in managing complicated deliveries and identifying signs that interventions are needed. These can range from IV fluids and/or medications to support labour, to an instrument-assisted delivery (vacuum cup or forceps) or Caesarean section.

Indirect causes, in particular complications from infectious disease, account for about 20 percent of maternal deaths.