When Labor StallsKatlyn Joy |27, March 2013
Every labor is different but we all hope for a smooth and relatively speedy birth. However, that is often not the case. There are a number of factors that can lead to stalled labor but probably the biggest is being a novice. First time mothers typically labor longer than second time moms because your pelvis has previously expanded to pass a baby and your body is more readily able to adapt childbirth having done it previously.
Doctors refer to a too slow labor as "failure to progress." The definition of exactly what is too slow however depends on who is making the decisions many times. Generally, an early labor that fails to produce consistent contractions resulting in a dilation of the cervix over a 20 hour period is considered "failure to progress."
If your bag of waters have ruptured and you are not in labor within 24 hours, you will likely need a cesarean as the clock has started. Any longer and you risk too little amniotic fluid in the womb for baby and possible infection.
What Happens When Labor Stalls?
If your amniotic sac has not ruptured and you have no such clock ticking down, early labor may stop and start over many hours, perhaps days, resulting in you probably being sent back home to wait for things to really get going.
If you are further along and your cervix has dilated more than a couple centimeters but stalls short of the full 10 centimeters, the reasons for such slowing can vary from problems with the baby's size, medical interventions slowing labor or other factors.
If you have dilated fully but things stall at the pushing stage, you are most likely a first-time mom or perhaps you are giving birth to a larger baby; or perhaps the baby is not positioned ideally, such as facing toward your back instead of your front.
The ways to get things going depends on what slowed you up in the first place.
Main Reasons for a Stalled Labor and Your Options
Stalled due to first time mom, and in early labor.
If you just don't seem to have consistent and productive contractions, you can do yourself a favor and take a walk. Being active and upright can get things going. If that's not successful, try a warm shower or bath. With doc's approval you can even try sex. It can get things started up, but this is only OK if your water hasn't broken. Another option is nipple stimulation which can release oxytocin, the same hormone doctors administer to induce labor. This can trigger strong contractions so only attempt this with detailed instructions from your physician.
Baby in posterior position.
If baby isn't in the right position for childbirth, head-down and facing up to your tummy, labor will likely prove sluggish. Try getting on your hands and knees and rocking gently. Your doctor may try some other measures to get baby to get into position. If none are successful, a vacuum extractor or forceps may be tried.
Having an epidural may provide a pain free labor, but it will likely add 40 to 90 minutes to your childbirth experience. Epidurals are known to slow labor down so consider that when offered this pain management.
Big baby/big head.
Mothers love to guilt their big-headed babies about their birth but it is true, babies with larger heads or of larger birth weights are tougher to birth especially for first time moms. Should your baby be of the bulkier breed, your labor will be watched carefully. While a slow labor may not be fun, as long as things don't stall altogether and you can keep your energy up, you will most likely get baby delivered vaginally with patience. However, your medical team will be carefully monitoring your baby to make sure that he is doing well with labor and his heart rate is strong. Should baby appear in distress, you will need a c-section.
If your contractions aren't building to a harder, faster and closer together pace, you are having inefficient contractions. If your activity and changing positions doesn't help, your doctor will probably try stripping your membranes. Sounds terrible but in actuality it involves the doctor inserting a crochet like instrument into cervix to poke a hole in your bag of waters. You'll feel a rush of warm water and hopefully strong contractions will soon follow. Should that fail to jump start things, probably some oxytocin will be administered via an IV to get contractions started or stronger. If after several hours you are still stalled, you will need a c-section in most cases.
Stalled at the pushing stage.
Usually first time moms experience this type of failure to progress. Often just some patience and encouragement for often a very tired mom is all that is needed. Baby will be monitored to ensure the baby is handling labor OK and if she is, giving yourself time to gather the strength needed may be enough. However, should you or baby be waning a bit, using forceps, a vacuum extractor or perhaps an episiotomy will probably be sufficient to birth the baby.
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