A recent federal study finds there has been a sharp increase in medical complications associated with childbirth which has forced hospitals to be better prepared.

Of the more than four million U.S. births every years, about 52,000 have complications, reports the Centers for Disease Control and Prevention (CDC) in a report issued in October. That may include a heart attack, kidney failure or respiratory distress. For every 10,000 women who delivered in a hospital there were 129 complications considered severe such as heart attack, bleeding, kidney failure.

The complications amount to a 75 percent increase over the decade prior to 2009.

More women today are obese, older or suffer from chronic conditions such as diabetes or congenital heart conditions. But they are not the only ones experiencing birth complications. With the sharp rise in caesarean section deliveries, up almost 60 percent in the past dozen years, increases the risk of hemorrhage.

Things can go wrong very quickly in a delivery room even when they shouldn’t, reports the Wall Street Journal. The WSJ reports on Danielle Dargatz who was having her fourth child when she began hemorrhaging in the delivery room at a Milwaukee hospital. Despite the efforts of her obstetrician to stop the bleeding with medication, it continued. Finally an emergency hysterectomy was performed and a mass delivery of blood.

To better prepare for incidents such as this, the CDC is funding improved guidelines for labor and delivery rooms and hospitals mirroring military-style emergency room teamwork protocols. In the case of Dargatz, the staff had conducted drills twice a month to prepare them for such unexpected emergencies. Drills include coordinating the team, communicating her condition, making sure carts are stocked with the medication and equipment needed to stop the bleeding.

These types of emergencies amount to an additional $17.4 in U.S. hospital costs every year, reports the WSJ quoting the Agency for healthcare Research and Quality.