If a “queen” or mother cat is reasonably healthy, it is highly unlikely that she will suffer from birthing difficulties. However, birth difficulties that include mechanical blockage and uterine inertia occur in some cats. Sometimes mechanical blockage happens when the kittens’ diameter is too wide for the queen’s birth canal diameter. Uterine inertia could come about when the uterus is too weak to contract.

Mechanical blockage and uterine inertia are most likely to take place with older cats, with queens who are obese and, with queens who birth small litters of relatively oversized kittens. These conditions are apt to occur in cat breeds with big heads and flat faces like Persians. It also frequently involves the birth of the first kitten or the last kitten.

If any of the following signs occur, call the veterinarian. It could help to save the life of the kittens as well as the mother

Mechanical Blockage: The "diving position" – exiting the birth canal with nose and feet first, and the back next to the vagina’s crown – is regularly how kittens are born. An oversized kitten or a kitten is situated wrong in the birth canal are the two main reasons for mechanical blockage. 

Uterine Inertia: When the uterine muscles become too weak, labor becomes futile. The uterus can’t generate contractions that are strong and effective. Reasons for uterine fatigue include:

Abnormal or difficult births in cats are typically caused by several factors, including uterine inertia, the birth canal is too small, the fetus crosses the birth channel in an atypical orientation, and/or the fetus is too large.

Veterinarians pay attention to the following situations and history:

The vet could also carry out a sterile digital exam to determine the degree of obstruction in the birth canal as well as the position and presentation of the fetuses. To determine the presence, mass, location and health of the fetuses, the veterinarian could also use radiography or ultrasound scans.

Should labor be prolonged, and the veterinarians cannot see or feel the kitten in the birth canal, an x-ray of the queen will help to determine the relative sizes and positions of the kittens.

A fractured pelvis is detrimental for queens. If a queen with a fractured pelvis becomes pregnant and it wasn’t known she had a fractured pelvis, she will have to undergo a surgery to give birth.

Veterinarians warn that a queen with a pelvic fracture should not get pregnant. X-ray scans, taken prior to pregnancy, are the way to determine if the queen suffers from this malady.

Medication: The source of some forms of uterine inertia is caused by a lack of oxytocin or calcium or both. To stimulate stronger contractions, the veterinarian may inject oxytocin (which is made by the pituitary gland) and calcium gluconate. There is danger associated with such injections, in that the uterus could rupture. 

Cesarean Section: If birthing difficulties can’t be resolved by the use of drugs or obstetric treatment, the veterinarian will determine whether a cesarean section is necessary. The veterinarian will decide if this common procedure, which is used when all sorts of birthing problems are present, is the best choice for the mother. The vet will take the following into consideration:

In most cases, a cesarean section presents no problems, especially if the queen is young and healthy. The veterinarian performs the operation under general anesthesia. There may be major problems if the labor is excessive and drawn out and toxicity occurs, i.e. the kittens are stillborn and starting to decay or if the uterus ruptures.

The veterinarian will consider medical management when obstruction of the birth canal and fetuses is constant, the appearance and location of the fetal position are correct, and there is no blockage in the birth canal. To encourage uterine contractions, the veterinarian could prescribe oxytocin. A cesarean section could be done if the oxytocin gets no reaction.

Surgery could be necessary for obstructive dystocia and birth difficulties along with distress or general poor health, extended active labor, primary uterine inertia and if health management is unproductive.

Within three hours of the surgery, the queen is expected to be stable, alert and capable of nursing her kittens. Reasons for having the cesarean section vary and just because the queen had the procedure when she had one litter does not necessarily mean that she will have to have another cesarean section when she has another litter.