This article covers the complications of childbirth (parturition, labour, delivery,) not those of pregnancy or the postpartum period. Even with modern obstetrics and pain control, childbirth is still an ordeal for many women. During delivery, or immediately afterwards, dramatic complications are occasionally seen - delirium, stupor, rage, acts of desperation or neonaticide. These complications will be briefly reviewed in turn. With the great improvement in obstetric care, most of them have become rare. There is, however, a great contrast between Europe, North America, Australia, Japan and some other countries with advanced medical care, and the rest of the world. The wealthiest nations produce only 10 million children each year, from a total of 135 million. They have a maternal mortality rate (MMR) of 6–20/100,000. Some poorer nations with high birth rates have an MMR more than 100 times as high, and, presumably, a corresponding prevalence of severe morbidity. In Africa, India & South East Asia, and Latin America, these complications of parturition may still be as important as they have been throughout human history. Although there has been some improvement since then , it is still true that about half the births in many nations are not supervised by skilled attendants. Under the name ‘parturient delirium’, this is defined  as an acute (usually sudden) clouding of consciousness, lasting minutes or hours, with full recovery. Onset is usually towards the end of labour, and recovery after the birth. Any of the following may be observed – incoherent speech, misidentification of persons, visual hallucinations, inappropriate behaviour such as singing, or memory loss for the episode. A phasic course, with alternate delirium and clarity, continuation into the puerperium, and recurrence after another pregnancy have been described in a few cases.

It was one of the first psychiatric disorders, related to childbearing, to be described, and its importance in the early 19th century is indicated by an early classification, stating that it was one of two recognized forms of puerperal insanity . More than 50 cases have been described, most of them in the epoch when parturition was endured without effective pain relief. The disorder has almost disappeared in nations with advanced obstetrics, with only two early 20th century reports . But, within the last ten years, there were 28 nations in which fewer than half the births were attended by skilled birth attendants; they included Nigeria, Pakistan, Ethiopia and Bangladesh, each with more than 3 million births/year. In 2012, it was estimated that 130-180 million infants would be delivered in the quinquennium 2011-2015 without skilled birth attendance. There are still many countries where parturition in the 21st century is like that in Europe in the early 19th century, and women are at risk of becoming delirious during labour.

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