A woman with five previous normal vaginal deliveries and a history of right salpingectomy for ectopic pregnancy has sudden pain in term labour, with epidural analgesia. A concurrent worsening of fetal heart rate pattern with bradycardia urges quick vacuum delivery. Maternal post-partum pain and hemoglobin (Hb) drop suggest intra-abdominal haemorrhage. The combination of sudden, strong intra-partum pain and fetal distress should raise the suspicion of intra-abdominal haemorrhage. After vaginal delivery an accurate follow-up is mandatory.