This chapter presents an overview of both maternal and infant birth injuries, considering their etiology, potential methods of avoidance, and critiques of current obstetric practices. The more significant maternal complications of parturition include birth canal lacerations, episiotomy extensions, other perineal or rectal injuries, and various degrees of intrapartum and postpartum hemorrhage. Certain clinical settings predispose to birth injury, including labor stimulation, dystocia/macrosomia, preterm delivery, the diagnosis of acute fetal jeopardy from any cause, and instrumental or cesarean delivery. Superficial maternal birth canal injuries such as soft-tissue abrasions, ecchymoses, or small lacerations are common enough to be considered normal. Vaginal and cervical lacerations, urinary tract dysfunction, uterine infection, uterine rupture are other specific maternal birth injuries discussed in the chapter. The most common direct fetal injury after maternal blunt trauma is a cranial fracture.