Hesperian Health Guides

Danger signs during labor

In this chapter:

Most women, including women with disabilities, give birth safely. But when something goes wrong during labor and birth, it is very important for a woman to get the care she needs to save her life. (For more information about safe labor and birth and the problems that can arise, see A Book for Midwives.) Here are some of the danger signs that can let you know when to get help:

Waters break but labor does not start within 24 hours

Go to a health center or hospital. When the waters have broken, the risk is much higher that you or your baby could get a serious infection. You may need to get fluids or medicines in the vein (intravenous, IV).

a health worker examining a woman whose baby is lying sideways in the womb.

Baby lying sideways

Go to a hospital. Do not try to change the position of the baby once labor has started. This can tear the womb or separate the placenta from the womb wall. A baby lying sideways cannot be born without an operation.

Bleeding before the baby is born

Go to the hospital right away. If you are bleeding bright red blood, it could mean the placenta is separating from the womb wall or is covering the opening of the womb. This is very dangerous.

Fever

Fever is usually a sign of infection. If your fever is not very strong, you may just need fluids. Drink plenty of water, tea, or juice, and try to pass urine every few hours.
If your fever is very high and you have chills, go to a health center or hospital. You need antibiotic medicines right away.

a very tired-looking pregnant woman wearing a leg brace.
A woman in labor should not see the sun rise twice.
Proverb from Niger

Too long labor

Go to a health center or hospital. When labor lasts longer than 1 day and 1 night, or if you are pushing hard for more than 2 hours, you may need medicines or an operation for the baby to be born.

Green or brown waters

If it is still early labor, or if the mother has not started pushing, it is best for this baby to be born in a hospital. When the bag of waters breaks, the water should be clear or a little pink. Brown or green waters mean the baby has probably passed stool inside the womb and could be in trouble.

If the mother is far along in her labor and the baby is going to be born soon, have the mother push as hard as she can and get the baby out quickly. As soon as the baby’s head is out, and before it takes its first breath, ask the mother to stop pushing. Wipe the baby’s mouth and nose with a finger wrapped in a clean cloth, or use a suction bulb to suck out the mucus. Once the nose and mouth have
been cleaned out, the mother can push the rest of the baby’s body out.

Pre-Eclampsia (Toxemia of Pregnancy)

Pre-eclampsia can lead to seizures and even death. If the mother has any of these danger signs,
go to a hospital right away:

  • strong headache
  • blurred or double vision
  • sudden, steady severe pain at the top of the
    belly, just below the high point between the ribs
  • overactive reflexes
  • high blood pressure
  • protein in the urine


If the mother starts to have a seizure and you know she does not have epilepsy:

a woman lying on the floor shaking with a cloth under her head.
  • Put something under her head to protect it, and put her on her left side if possible. But do not try to hold her down.
  • Keep her cool.
  • Take her to the nearest hospital.


A woman who has epilepsy can also get toxemia.

This page was updated:30 Nov 2023