Labor involves rhythmic, involuntary, or medically induced uterine contractions that result in the effacement (thinning and shortening) and dilation of the cervix. According to the World Health Organization (WHO), normal birth features spontaneous onset, low-risk conditions at labor's start, a vertex-positioned infant born between 37 and 42 weeks of pregnancy, and good post-delivery health for both mother and baby [1, 2].

Expectant parents should have access to various childbirth settings, including hospitals and birthing centers. Hospitals offer immediate access to clinical staff and critical equipment essential for managing emergencies like placental abruption, shoulder dystocia, or emergency cesarean sections. Hospital settings also effectively manage postpartum complications such as hemorrhage [3]. The support from a partner or doula during labor can lower anxiety and enhance the childbirth experience. Childbirth education classes are beneficial, offering information on normal labor processes, monitoring equipment, and potential complications [3]. Beyond the physical location, childbirth settings shape how labor and delivery unfold, influencing medical interventions, cultural or community-based practices, and personalized birth plans that impact pain management, labor positions, and support options. 

Patients and their partners should receive comprehensive information about the advantages, disadvantages, risks, and challenges associated with various childbirth settings. This enables informed decision-making based on individual circumstances, discussions with medical professionals, and personal preferences. Making informed choices helps expectant parents feel confident and prepared, contributing to positive childbirth experiences and minimizing potential risks [4, 5].

The quality of care significantly affects maternal health during childbirth. Historically, insufficient availability of skilled obstetric providers correlates with high maternal mortality, particularly in low-income countries where traditional birth attendants often served as primary caregivers. Although traditional birth attendants have practical experience, their limited formal medical training contributes to increased maternal mortality risks without skilled medical intervention [6]. The WHO advocates for skilled birth attendants to lower maternal mortality and ensure access to critical interventions such as cesarean sections and antibiotics [6]. Hemorrhage remains the leading cause of maternal mortality worldwide, resulting from conditions such as uterine atony, retained products of conception, or lacerations. Effective management is essential to prevent severe complications [6].

Common childbirth complications include a variety of medical issues that can occur during pregnancy, labor, or delivery, potentially impacting the health of both mother and infant. While most pregnancies progress without significant problems, recognizing and managing these complications promptly is essential. Complications can range from minor concerns to severe, life-threatening conditions. 

The growing prevalence of childbirth complications has raised concerns in maternal healthcare, particularly due to disparities influenced by socio-economic status, and access to quality care. Research shows that women from marginalized communities experience higher rates of complications and adverse outcomes during pregnancy and childbirth, highlighting systemic inequities in healthcare access and treatment. Ongoing discussions on maternal health disparities emphasize the critical need forcomprehensive strategies to reduce these inequities and enhance overall maternal care [7, 8].

Umbilical cord prolapse happens when the umbilical cord slips ahead of the baby during delivery, potentially compromising the baby’s oxygen supply. Immediate medical intervention is crucial to prevent severe complications, including brain damage [9].

Prolonged labor occurs when labor lasts longer than expected. This condition increases morbidity and mortality risks for both mother and baby, potentially caused by factors such as large cephalo-pelvic disproportion, or malposition of the infant [10, 11].

Shoulder dystocia is a serious obstetric emergency that occurs during vaginal delivery when the fetal shoulders fail to deliver after the head has emerged. This typically happens when the anterior shoulder becomes stuck behind the pubic symphysis or the posterior shoulder is obstructed by the sacral promontory [12, 13]. The condition can lead to severe complications, including brachial plexus injuries, fetal hypoxia, fractures, and maternal trauma such as hemorrhage or lacerations. 

In addition to physical risks, shoulder dystocia can have a lasting emotional and psychological impact on families. The stress of a traumatic birth, combined with concerns about long-term outcomes, often leads to significant distress and, in some cases, legal action against healthcare providers [14]. These realities highlight the importance of timely management, clear communication, and ongoing support for affected families.

Healthcare providers classify perineal tears into four degrees. First- and second-degree tears are minor and typically heal without significant issues [15]. However, third- and fourth-degree tears are more severe and can cause lasting symptoms such as dyspareunia (painful intercourse), perineal pain, fistulas, and incontinence, significantly affecting a woman's quality of life [15, 16]. Severe tears often lead to complications if treated by less experienced healthcare practitioners, emphasizing the importance of care provided by trained physicians [16].

Antepartum hemorrhage (APH) refers to vaginal bleeding that occurs from the 24th week of pregnancy until delivery [17] [26]. It poses serious risks to both mother and baby, making timely diagnosis and management essential. The most common causes include placental abruption, where the placenta detaches prematurely from the uterine wall, and placenta previa, in which the placenta partially or completely covers the cervix. Other contributing factors can include local cervical or vaginal lesions and infections [17] [26]. Symptoms may range from painless bleeding to abdominal pain and signs of fetal distress, depending on the cause and severity [18] [27]. With prompt care by experienced clinicians, outcomes are often favorable; however, potential complications include maternal anemia, hypovolemic shock, and fetal hypoxia or death in severe cases [19] [28].

Uterine rupture is a rare but life-threatening complication involving a tear in the uterine wall during labor. This condition can cause severe bleeding and ranks among the most dangerous obstetric emergencies [20].

Various infections can complicate labor and delivery, including chorioamnionitis, a maternal bacterial infection of the amniotic fluid and membranes. Early detection and prompt treatment are essential to minimize risks for both mother and baby [21].

Birthing in low-resource, low-income settings involves significant challenges regarding maternal and neonatal health due to limited healthcare resources. Maternal and neonatal mortality rates in these areas are substantially higher compared to high-income countries, with maternal mortality rates often being 50 to 100 times greater in certain low- and middle-income regions [6]. 

About three-quarters of maternal deaths and a considerable number of neonatal deaths occur around delivery, highlighting the critical need for accessible facility-based care and emergency medical interventions [6]. Childbirth complications like hemorrhage and hypertensive disorders are common in these settings, requiring timely and effective healthcare responses to prevent fatalities [22, 23]. 

Improving birthing conditions in low-resource environments requires a comprehensive strategy, including enhancing healthcare infrastructure, expanding community-based health initiatives, and increasing political and financial commitments to maternal and neonatal care [24, 25]. However, ongoing barriers, such as discriminatory family structures, physical access challenges, and shortages of skilled healthcare personnel, continue to complicate maternal care delivery in these regions [26-28].