Abruptio placentae

Very occasionally the placenta becomes partially or completely detached from the wall of the uterus before the baby is born. This can cause sudden bleeding which may put the mother and baby at risk. It is important to get medical aid immediately.

Acceleration of labour

Occasionally labour slows down or stops, but can be speeded up with the use of the synthetic hormone syntocinon given by an intravenous drip into a vein in the mother's arm.

Afterpains

After the baby is born the womb, or uterus, shrinks back to almost the same size as it was before pregnancy. Breastfeeding helps this process as the hormones produced while feeding also make the uterus contract. Afterpains tend to be stronger with second and later babies and some women need to take paracetamol to help them cope with the pains for the first few days.

Alpha fetoprotein (AFP)

This is a protein produced by the baby which is also found in the amniotic fluid and crosses into the mother’s blood. The level of AFP can be checked in a sample of the mother’s blood, and used for antenatal screening. Unexpectedly high or low levels can be an indication of certain conditions such as spina bifida or Down’s syndrome.

Amniotic fluid

The baby floats inside the amniotic sac, a double walled sac filled with amniotic fluid. This watery environment protects the baby as he grows and allows him to move around freely. Too much or too little amniotic fluid can indicate a problem with the baby. Some of the baby’s cells are present in the amniotic fluid so if necessary a sample of the fluid can be taken and checked to detect certain conditions in the baby such as Down’s syndrome. See Amniocentesis.

Anal fissure

A small tear or crack in the lining of the back passage caused by bruising during the birth. The main symptom is a sharp pain on opening the bowels. A high fibre diet, plenty of fluids and suppositories to coat the lining of the back passage will all help to heal it.

Apgar

An assessment of the baby’s general wellbeing, carried out immediately after birth and again 5 minutes later. The baby’s condition is given a score out of 10. Any baby with a low Apgar will be seen by a paediatrician.

Artificial rupture of membranes (ARM)

To speed up or induce labour the bag of waters may be broken by the midwife using a hooked instrument. This is often carried out in conjunction with a drip of a synthetic hormone into the arm to stimulate contractions.

Assisted delivery

A baby who is taking a long time to be born, or is showing signs of distress, may need assistance to speed up the birth. Forceps and ventouse are the two main ways of assisting a delivery.