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1. Due to Indolence: After pregnancy, blood nourishes the fetus, and Qi protects the mother and fetus. It is advisable to engage in regular movement to ensure the free circulation of Qi and Blood, keeping the Bao Tai (uterus/fetus) active. Prolonged sitting or lying down may cause Qi stagnation and impaired Blood flow, leading to fetal lethargy and difficult labor. This can be inferred from the observation that women engaged in field labor often give birth easily when sudden abdominal pain occurs during their journey.

2. Due to Excessive Nourishment: The fatness or thinness of the fetus is connected to the mother via Qi. What the mother craves becomes the nourishment for the fetus. Indulging in rich and heavy flavors without moderation leads to an overly large fetus, resulting in difficult labor. This is evident from the fact that women accustomed to coarse food give birth easily.

3. Due to Sexual Desire: In ancient times, pregnant women would reside in separate quarters and not share a bed with their husbands, as sexual desire was strictly prohibited. The fetus resides in the Bao Zhong (uterus) and relies entirely on Qi and Blood for nourishment. Stillness allows the Shen (Spirit) to remain contained; however, if sexual desire arises, Qi and Blood are consumed, internal heat disturbs the body, and Qi and Blood boil. If this occurs within the first three months of pregnancy, it may lead to fetal movement disorders or spontaneous abortion. If it occurs after three months, it may result in a thickened Bao Yi (placenta/membranes) causing difficult labor, or leakage of the Yuan Qi (Original Qi), resulting in children who are fat and fair-skinned but short-lived, prone to sores, toxins, and smallpox, which are difficult to treat. Furthermore, while humans and animals both derive life from Qi, human births are not always smooth or successful for every fetus, whereas horses, cattle, dogs, and pigs give birth easily with no loss. Why? Because these animals cease mating immediately after conception, whereas humans cannot abstain from intercourse during pregnancy, let alone those who indulge without restraint.

4. Due to Worry and Doubt: Although people today are eager to conceive, their plans for protecting the fetus are often negligent. Some consult fortune-tellers or pray to deities; others hear of birth complications and live in constant fear. This anxiety causes the Heart Shen to be unsettled and Qi to become timid, leading to difficult labor.

5. Due to Weakness and Timidity: Young women giving birth for the first time may have weak Shen Qi and an unrelaxed Zi Hu (birth canal). Coupled with a hunched back and inability to straighten up, they toss and turn, preventing the fetus from descending. Additionally, middle-aged women who have given birth many times may suffer from deficient Qi and Blood, making labor difficult.

6. Due to Panic: Some incompetent midwives fail to distinguish between normal delivery (Zheng Chan) and abnormal presentation (Nong Chan). Upon seeing abdominal pain, they hastily instruct the woman to push. Lacking confidence, the woman complies, leading to malpresentation (transverse or breech) and injury to both mother and child. This is all due to panic and haste.

7. Due to Deficiency and Exhaustion: When labor begins, if the fetus has not yet descended, pushing too early exhausts the mother's strength. By the time the fetus is ready to emerge, the mother is depleted, causing the fetus to stall. This results in dryness of the birth passage and difficult labor. In such cases, Bu Xue Cui Sheng Tang (Blood-Nourishing Labor-Inducing Decoction) or, preferably, Bao Chan Wan Quan Tang (Decoction for Complete Safety in Childbirth) should be used.