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1. Due to excessive comfort and inactivity: After pregnancy, blood nourishes the fetus, and Qi protects it. 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 stagnation of Qi movement and sluggishness of Blood flow, leading to a stagnant and inactive fetus, thus resulting in difficult labor. This can be inferred from the observation that women engaged in field labor often experience sudden abdominal pain during their journey and deliver immediately.

2. Due to excessive nourishment (improper diet): The fatness or thinness of the fetus is connected to the mother's Qi and Blood; what the mother craves and consumes becomes the nourishment for the fetus. Indulging in rich and heavy flavors without moderation leads to an overly large fetus, causing difficult labor. This can be inferred from the ease with which women accustomed to coarse food give birth.

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. If sexual desire arises, Qi and Blood are consumed, fire disturbs the interior, and Qi and Blood boil. If this occurs within the first three months of pregnancy, it may easily cause fetal movement, miscarriage, or premature delivery. If it occurs after three months, it may result in a thickened placental membrane leading to difficult labor, or leakage of the Yuan Qi (Original Qi), resulting in children who are often fat and fair-skinned but short-lived, prone to sores, toxins, and smallpox-like diseases that are difficult to treat. Furthermore, although humans and animals both derive life from Qi, human births are not always smooth or every child survives, whereas horses, cattle, dogs, and pigs give birth easily and without loss. Why? Because after conception, male and female animals do not mate, whereas humans cannot abstain from intercourse after conception, let alone those who indulge without restraint.

4. Due to worry and doubt: Although people today have an urgent desire for children, their plans for protecting the fetus are often negligent. Some consult fortune-tellers or pray to deities; others hear of complications in other births and constantly harbor fear and anxiety. This causes the heart to be unsettled and Qi to become weak, making labor difficult.

5. Due to weakness and timidity: For young women giving birth for the first time, the Shen Qi (Spirit and Qi) may be timid and weak, and the Zi Hu (cervix/uterine opening) may not yet be relaxed. Coupled with bending the waist and inability to straighten, rolling and turning restlessly, the fetus cannot emerge. Similarly, middle-aged women who have given birth many times may suffer from deficiency of Qi and Blood, also resulting in difficult labor.

6. Due to panic and haste: Some incompetent midwives fail to distinguish between normal labor (Zheng Chan) and abnormal labor (Nong Chan). Upon seeing abdominal pain, they hastily instruct the parturient woman to exert effort. Lacking inner composure, the woman complies, leading to malpresentations such as transverse or breech positions, injuring both mother and child. These injuries are all due to the error of panic and haste.

7. Due to deficiency and exhaustion: During labor, if the fetus has not yet descended, pushing too early will exhaust the mother's strength before the fetus is ready to emerge. When the fetus finally attempts to descend, the mother lacks strength, causing the fetus to stall. This results in dryness and astringency of the birth canal, making labor difficult. In such cases, Bu Xue Cui Sheng Tang (Blood-Nourishing Labor-Inducing Decoction) can be used, and Bao Chan Wan Quan Tang (Decoction for Complete Safety in Childbirth) is considered most effective.