Factors increasing the risk (to either the woman, the fetus/es, or both) of pregnancy complications beyond the normal level of risk may be present in a woman's medical profile either before she becomes pregnant or during the pregnancy. These pre-existing factors may relate to physical and/or mental health, and/or to social issues, or a combination.

Some common risk factors include:

- Age of either parent

- Adolescent parents

- Older parents

- Exposure to environmental toxins in pregnancy

- Exposure to recreational drugs in pregnancy:

- Ethanol during pregnancy can cause fetal alcohol syndrome and fetal alcohol spectrum disorder.

- Tobacco smoking and pregnancy, when combined, causes twice the risk of premature rupture of membranes, placental abruption and placenta previa. Also, it causes 30% higher odds of the baby being born prematurely.

- Prenatal cocaine exposure is associated with, for example, premature birth, birth defects and attention deficit disorder.

- Prenatal methamphetamine exposure can cause premature birth and congenital abnormalities. Other investigations have revealed short-term neonatal outcomes to include small deficits in infant neurobehavioral function and growth restriction when compared to control infants. Also, prenatal methamphetamine use is believed to have long-term effects in terms of brain development, which may last for many years.

- Cannabis in pregnancy is possibly associated with adverse effects on the child later in life.

- Exposure to Pharmaceutical drugs in pregnancy. Anti-depressants, for example, may increase risks of such outcomes as preterm delivery.

- Ionizing radiation

- Risks arising from previous pregnancies:

- Complications experienced during a previous pregnancy are more likely to recur.

- Many previous pregnancies. Women who have had five previous pregnancies face increased risks of very rapid labor and excessive bleeding after delivery.

- Multiple previous fetuses. Women who have had more than one fetus in a previous pregnancy face increased risk of mislocated placenta.

- Multiple pregnancy, that is, having more than one fetus in a single pregnancy.

- Social and socioeconomic factors. Generally speaking, unmarried women and those in lower socioeconomic groups experience an increased level of risk in pregnancy, due at least in part to lack of access to appropriate prenatal care.

- Unintended pregnancy. Unintended pregnancies preclude preconception care and delays prenatal care. They preclude other preventive care, may disrupt life plans and on average have worse health and psychological outcomes for the mother and, if birth occurs, the child.

- Height. Pregnancy in women whose height is less than 1.5 meters (5 feet) correlates with higher incidences of preterm birth and underweight babies. Also, these women are more likely to have a small pelvis, which can result in such complications during childbirth as shoulder dystocia.

- Weight

- Low weight: Women whose pre-pregnancy weight is less than 45.5 kilograms (100 pounds) are more likely to have underweight babies.

- Obese women are more likely to have very large babies, potentially increasing difficulties in childbirth. Obesity also increases the chances of developing gestational diabetes, high blood pressure, preeclampsia, experiencing postterm pregnancy and/or requiring a cesarean delivery.

- Intercurrent disease in pregnancy, that is, a disease and condition not necessarily directly caused by the pregnancy, such as diabetes mellitus in pregnancy, SLE in pregnancy or thyroid disease in pregnancy.

Some disorders and conditions can mean that pregnancy is considered high-risk (about 6-8% of pregnancies in the USA) and in extreme cases may be contraindicated. High-risk pregnancies are the main focus of doctors specialising in maternal-fetal medicine.

Serious pre-existing disorders which can reduce a woman's physical ability to survive pregnancy include a range of congenital defects (that is, conditions with which the woman herself was born, for example, those of the heart or , some of which are listed above) and diseases acquired at any time during the woman's life.

In a survey in New York city 35% of nursing mothers stopped breastfeeding after one week due to the pain of cracked nipples. Thirty percent stopped breastfeeding between weeks one and three. Another survey of breastfeeding mothers in Brazil reported that there was 25% higher risk of interruption of exclusive breastfeeding when the women had cracked nipples. Mothers with higher education levels are more likely to continue breastfeeding despite the pain of cracked nipples.

The importance of preventing cracked nipples while breastfeeding has been reported. In an informal survey of breastfeeding in the UK, some mothers reported that they stopped breastfeeding because the cracked nipples made it too painful.

Individuals with inverted nipples may find that their nipples protract (come out) temporarily or permanently during pregnancy, or as a result of breastfeeding. Most women with inverted nipples who give birth are able to breastfeed without complication, but inexperienced mothers may experience higher than average pain and soreness when initially attempting to breastfeed. When a mother uses proper breastfeeding technique, the infant latches onto the areola, not the nipple, so women with inverted nipples are actually able to breastfeed without any problem. An infant that latches on well may be able to slush out an inverted nipple. The use of a breast pump or other suction device immediately before a feeding may help to draw out inverted nipples. A hospital grade electric pump may be used for this purpose. Some women also find that using a nipple shield can help facilitate breastfeeding. Frequent stimulation such as sexual intercourse and foreplay (such as nipple sucking) also helps the nipple protract.

Oxytocin is typically used right after the delivery of the baby to prevent PPH. Misoprostol may be used in areas where oxytocin is not available. Early clamping of the umbilical cord does not decrease risks and may cause anemia in the baby, thus is usually not recommended.

Active management of the third stage is a method of shortening the stage between when the baby is born and when the placenta is delivered. This stage is when the mother is at risk of having a PPH. Active management involves giving a drug which helps the uterus contract before delivering the placenta by a gentle but sustained pull on the umbilical cord whilst exerting upward pressure on the lower abdomen to support the uterus.

Another method of active management which is not recommended now is fundal pressure. A review into this method found no research and advises controlled cord traction because fundal pressure can cause the mother unnecessary pain. Allowing the cord to drain appears to shorten the third stage and reduce blood loss but evidence around this subject is not strong enough to draw solid conclusions.

Nipple stimulation and breastfeeding triggers the release of natural oxytocin in the body, therefore it is thought that encouraging the baby to suckle soon after birth may reduce the risk of PPH for the mother. A review looking into this did not find enough good research to say whether or not nipple stimulation did reduce PPH. More research is needed to answer this question.

Causes of postpartum hemorrhage are uterine atony, trauma, retained placenta, and coagulopathy, commonly referred to as the "four Ts":

- Tone: uterine atony is the inability of the uterus to contract and may lead to continuous bleeding. Retained placental tissue and infection may contribute to uterine atony. Uterine atony is the most common cause of postpartum hemorrhage.

- Trauma: Injury to the birth canal which includes the uterus, cervix, vagina and the perineum which can happen even if the delivery is monitored properly. The bleeding is substantial as all these organs become more vascular during pregnancy.

- Tissue: retention of tissue from the placenta or fetus may lead to bleeding.

- Thrombin: a bleeding disorder occurs when there is a failure of clotting, such as with diseases known as coagulopathies.

In Rinker's study, 55% of respondents reported an adverse change in breast shape after pregnancy. Many women mistakenly attribute the changes and their sagging breasts to breastfeeding, and as a result some are reluctant to nurse their infants. Research shows that breastfeeding is not the factor that many thought it was. Rinker concluded that "Expectant mothers should be reassured that breastfeeding does not appear to have an adverse effect upon breast appearance." Also discounted as causes affecting ptosis are weight gain during pregnancy and lack of participation in regular upper body exercise.

According to Rinker's research, there are several key factors. A history of cigarette smoking "breaks down a protein in the skin called elastin, which gives youthful skin its elastic appearance and supports the breast." The number of pregnancies was strongly correlated with ptosis, with the effects increasing with each pregnancy. As most women age, breasts naturally yield to gravity and tend to sag and fold over the inframammary crease, the lower attachment point to the chest wall. This is more true for larger-breasted women. The fourth reason was significant weight gain or loss (greater than ). Other significant factors were higher body mass index and larger bra cup size.

The most common causes of nipple inversion include:

- Born with condition

- Trauma which can be caused by conditions such as fat necrosis, scars or it may be a result of surgery

- Breast sagging, drooping or ptosis

- Breast cancer

- breast carcinoma

- Paget's disease

- Inflammatory Breast Cancer (IBC)

- Breast infections or inflammations

- mammary duct ectasia

- breast abscess

- mastitis

- Genetic variant of nipple shape such as

- Weaver syndrome

- congenital disorder of glycosylation type 1A & 1 L

- Kennerknecht-Sorgo-Oberhoffer syndrome

- Gynecomastia

- Holoprosencephaly, recurrent infections and monocytosis

- Tuberculosis

Around 10–20% of all women are born with this condition. Most common nipple variations that women are born with are caused by short ducts or a wide areola muscle sphincter.

Inverted nipples can also occur after sudden and major weight loss.

In 2013 it resulted in 19,000 maternal deaths down from 29,000 deaths in 1990.

Nipple discharge refers to any fluid that seeps out of the nipple of the breast. Discharge from the nipple does not occur in lactating women. And discharge in non-pregnant women or women who are not breasfeeding may not cause concern. Men that have discharge from their nipples are not typical. Discharge from the nipples of men or boys may indicate a problem. Discharge from the nipples can appear without squeezing or may only be noticeable if the nipples are squeezed. One nipple can have discharge while the other does not. The discharge can be clear, green, bloody, brown or straw-colored. The consistenct can be thick, thin, sticky or watery.

Some cases of nipple discharge will clear on their own without treatment. Nipple discharge is most often not cancer (benign), but rarely, it can be a sign of breast cancer. It is important to find out what is causing it and to get treatment. Here are some reasons for nipple discharge:

- Pregnancy

- Recent breastfeeding

- Rubbing on the area from a bra or t-shirt

- Trauma

- Infection

- Inflammation and clogging of the breast ducts

- Noncancerous pituitary tumors

- Small growth in the breast that is usually not cancer

- Severe underactive thyroid gland (hypothyroidism)

- Fibrocystic breast (normal lumpiness in the breast)

- Use of certain medicines

- Use of certain herbs, such as anise and fennel

- Widening of the milk ducts

- Intraductal pipilloma

- Subareolar abscess

- Mammary duct ectasia

- Pituitary tumor

Sometimes, babies can have nipple discharge. This is caused by hormones from the mother before birth. It usually goes away in 2 weeks. Cancers such as Paget disease (a rare type of cancer involving the skin of the nipple) can also cause nipple discharge.

Nipple discharge that is NOT normal is bloody, comes from only one nipple, or comes out on its own without squeezing or touching the nipple. Nipple discharge is more likely to be normal if it comes out of both nipples or happens when the nipple is squeezed. Squeezing the nipple to check for discharge can make it worse. Leaving the nipple alone may make the discharge stop.

If cesarean section is obtained in a timely manner, prognosis is good. Prolonged obstructed labour can lead to stillbirth, obstetric fistula, and maternal death.

Fissure of the nipple is a condition that can be caused by friction that can result in soreness, dryness or irritation to, or bleeding of, one or both nipples during breastfeeding. It can also be the result of the friction of clothing against the nipple during physical exercise. This condition is also experienced by women who breastfeed and by surfers who do not wear rash guards.

Initially, an evaluation of malignancy is always indicated. If no abnormality is found, then a surgical duct excision may resolve the symptoms. Treatment also depends on whether single-duct or multiple-duct discharge is present, and whether the symptoms of nipple discharge are distressing to the patient. In some cases, there may be no need for any further intervention; in others, microdochectomy or a total duct excision may be appropriate. If the patient wishes to conserve the ability to breastfeed and only single-duct discharge is present, then ductoscopy or galactography should be considered in view of performing a localised duct excision. Once the cause of the nipple discharge is found, it will be treated by the health provider who will evaluate:

- Whether changing any medicine that has caused the discharge is appropriate

- Whether any lumps should be removed

- Whether some or all of the breast ducts should be removed

- If a prescription for cream to treat skin changes around the nipple will be helpful

- If medicines to treat a health condition are required

If all the tests are normal, treatment may not be necessary. A follow up mamogram mammogram and physical exam may be prescribed within 1 year.

Labial fusion is not uncommon in infants and young girls. It is most common in infants between the ages of 13 and 23 months, and has an incidence of 3.3% in this age group. It is estimated that labial fusion occurs in 1.8% of all prepubertal girls. It is rare in adult women, particularly in reproductive age, but is occasionally found in postpartum and postmenopausal women.

An epidural is a procedure that involves placing a tube (catheter) into the lower back, into a small space below the spinal cord. Small doses of medicine can be given through the tube as needed throughout labor. With a spinal block, a small dose of medicine is given as a shot into the spinal fluid in the lower back. Spinal blocks usually are given only once during labor. Epidural and spinal blocks allow most women to be awake and alert with very little pain during labor and childbirth. With an epidural, pain relief starts 10 to 20 minutes after the medicine has been given. The degree of numbness felt can be adjusted. With spinal block, good pain relief starts right away, but it only lasts 1 to 2 hours.

Although movement is possible, walking may not be if the medication affects motor function. An epidural can lower your blood pressure, which can slow your baby's heartbeat. Fluids given through IV are given to lower this risk. Fluids can cause shivering. But women in labor often shiver with or without an epidural. If the covering of the spinal chord is punctured by the catheter, a bad headache may develop. Treatment can help the headache. An epidural can cause a backache that can occur for a few days after labor. An epidural can prolong the first and second stages of labor. If given late in labor or if too much medicine is used, it might be hard to push when the time comes. An epidural increases risk of assisted vaginal delivery.

The primary contributing factor to labial fusion is low estrogen levels. A vulva with low estrogen exposure, such as that of a preadolescent, has delicate epithelial lining and is therefore vulnerable to irritation. Conditions causing irritation, such as infection, inflammation and trauma, cause the edges of the labia minora to fuse together. The fusion typically begins at the posterior frenulum of the labia minora and continues anteriorly.

Most labial adhesions resolve spontaneously before puberty as estrogen levels increase and the vaginal epithelium becomes cornified.

Perineal pain after childbirth has immediate and long-term negative effects for women and their babies. These effects can interfere with breastfeeding and the care of the infant. The pain from injection sites and possible episiotomy is managed by the frequent assessment of the report of pain from the mother. Pain can come from possible lacerations, incisions, uterine contractions and sore nipples. Appropriate medications are usually administered. Routine episiotomies have not been found to reduce the level of pain after the birth.

Vaginal gas that involves strong odor or fecal matter may be a result of colovaginal fistula, a serious condition involving a tear between the vagina and colon, which can result from surgery, child birth, diseases (such as Crohn's disease), and other causes. This condition can lead to urinary tract infection and other complications. Vaginal gas can also be a symptom of an internal female genital prolapse, a condition most often caused by childbirth.

Puffs or small amounts of air passed into the vaginal cavity during cunnilingus will not cause any known issues, however "forcing" or purposely blowing air at force into the vaginal cavity can cause an air embolism, which in very rare cases can be potentially dangerous for the woman, and if pregnant, for the fetus.

Some women who have pain in one or both breasts may fear breast cancer. However, breast pain is not a common symptom of cancer. The great majority of breast cancer cases do not present with symptoms of pain, though breast pain in older women is more likely to be associated with cancer.

Birth injuries that result in the formation of fistulas and urinary and fecal incontinence have been found to be strongly associated with economic and cultural factors. Teenagers and women who sustain injuries that develop into ureterovaginal fistulas during childbirth suffer significant social stigma. Ureterovaginal fistulas related to prolonged, obstructed labor are rare in developed nations but are more common in countries where access to emergent obstetrical care is limited.

Birth can be traumatic in different ways. Medical problems can result in interventions that can be frightening. The near death of a mother or baby, heavy bleeding, and emergency operations are examples of situations that can cause psychological trauma. Premature birth may be traumatic.

Emotional difficulties in coping with the pain of childbirth can also cause psychological trauma. Lack of support, or insufficient coping strategies to deal with the pain are examples of situations that can cause psychological trauma. However, even normal birth can be traumatic, and thus PTSD is diagnosed based on symptoms of the mother and not whether or not there were complications.

Additionally, in the process of birth, medical professionals who are there to aid the birthing mother may need to examine and perform procedures in the genital regions.

The following are correlated with PTSD:

- Medical complications before, during, or after childbirth:

- Pregnancy complications

- Emergency C-section

- Instrumental delivery

- Episiotomy

- Severe pain during birth

- Postpartum complications

- Preterm labour

- History of infertility

- Inadequate care during labour

- Social, psychological, and other factors:

- Unwanted pregnancy

- Low socioeconomic status

- Primiparous (first labour)

- Parenting (infant caring) problems

- Social support following childbirth

- Cultural factors

- History of mental health issues

- Other life stressors

Vaginal flatulence is an emission or expulsion of air from the vagina. It may occur during or after sexual intercourse or during other sexual acts, stretching or exercise. The sound is somewhat comparable to flatulence from the anus but does not involve waste gases and thus often does not have a specific odor associated. Slang terms for vaginal flatulence include vart, queef, and fanny fart (mostly British).

Cyclical breast pain (cyclical mastalgia) is often associated with fibrocystic breast changes or duct ectasia and thought to be caused by changes of prolactin response to thyrotropin. Some degree of cyclical breast tenderness is normal in the menstrual cycle, and is usually associated with menstruation and/or premenstrual syndrome (PMS).

Noncyclical breast pain has various causes and is harder to diagnose. Noncyclical pain has frequently its root cause outside the breast. Some degree of non-cyclical breast tenderness can normally be present due to hormonal changes in puberty (both in girls and boys), in menopause and during pregnancy. After pregnancy, breast pain can be caused by breastfeeding. Other causes of non-cyclical breast pain include alcoholism with liver damage (likely due to abnormal steroid metabolism), mastitis and medications such as digitalis, methyldopa (an antihypertensive), spironolactone, certain diuretics, oxymetholone (an anabolic steroid), and chlorpromazine (a typical antipsychotic). Also, shingles can cause a painful blistering rash on the skin of the breasts.