So, what exactly is prolonged labor? Can anyone really put a timestamp on how long it should take to have a baby? For some women, it seems to be a couple hours, and for others it might be three days. The starting point for determining whether labor is prolonged is to compare it to itself, not to the progression anyone else makes.
After all, we're all different.
If a woman is in labor for more than 18 hours, it is considered prolonged labor. Understand that this isn’t really a diagnosis of a condition, rather it’s more of a term that is used to describe a lengthy labor. It doesn’t mean that any kind of intervention is necessary.
That being said, sometimes women will need help to push things along.
Now then, that help does not always need to come in the form of drugs or medical interventions. Sometimes, it’s simply a matter of helping a woman to stop doing something that is delaying things.
That’s right. Sometimes, mom needs to get out of her own head or take a different direction to get things flowing freely again. This is easier than it sounds most of the time.
For a laboring woman who is stressed, she’ll need to relax. If she's scared, she'se going to have to find that inner calmness that will bring her baby into her arms. If she's feeling tired, try to sleep between contractions. Yes, that’s possible, lots of women do it even without pain relief.
If the pain mom-to-be is feeling during labor starts to feel stronger in the thighs or sides, this can also be a sign of prolonged labor. So is elevated blood pressure, an increased pulse, trouble breathing, and overall exhaustion.
Don't misunderstand, the aim here isn’t to blame women for lengthening their labors, instead the goal is to empower women to know they have more control than they think they do over their labors and how they progress.
15 Staying In Bed
Every woman you ever saw in the movies or on TV was giving birth on their back in a hospital bed, right? I mean, we can’t start empowering women and showing what really happens in the delivery room.
What would women do if they suddenly knew they were allowed to get out of bed and walk around, bounce on a birthing ball, sit on a stool, get into the tub or shower, or use a squatting bar to help them push while sitting more upright?
They might start getting the idea that they don’t want to be strapped down to a bed full of monitors writhing in pain while they give birth.
Get moving! Dance that baby out if you want. Rock on your hands and knees. Heck, you can even birth that way. Lean on your partner like you’re back in middle school with your arms draped around his neck and your pelvis open. Let gravity and your body do all the work.
Neither are effective if you’re lying in bed immobile.
14 Not Seeing A Chiropractor
A lot of women have never even been to a chiropractor before. So, suggesting they start when they are carrying a baby in their belly can sound startling to some. Fear not, ladies! The chiropractor is one of the best interventions you can ever come across during pregnancy.
First and foremost, you definitely want to make sure any chiropractor that you see is trained in the Webster treatment method.
Staying in proper alignment will make for a much more comfortable pregnancy. It alleviates compression in the joints — which can feel some real wear and tear during pregnancy. Most importantly, it keeps the pelvis aligned.
This is crucial for the baby to be able to get into the left occiput position, which is the best position for a vaginal delivery. The better engaged baby is in the right direction, the more likely labor will be easy breezy. Yes, some labors really are!
13 Pushing Only On Their Backs
Mommas of the world, this cannot be stressed enough. Get off your backs! This is the absolute worst position to push in. Miraculously, when birth is entertained with a better position, the whole process runs much more smoothly. Laboring on our backs leads to more tearing.
It's less likely that baby will be in a good position if you aren’t, and it delays labor overall.
When you think about, it actually makes a lot of sense that trying to push eight pounds of mass through the birth canal would happen more quickly with more control and less conflict if upright. Throughout history, women birthed in many positions.
Hands and knees is quite popular, as well as squatting. Some women even push lying propped up on their sides. The use of birthing peanuts can help get into this position. The idea of birthing on our backs only came about the use of the epidural, which renders women fairly numb and unable to control their bodies.
12 Asking For Drugs
Hey, there’s no shame in that game. It’s wonderful that women now have the option to choose what kind of birth they want to experience. However, that choice doesn’t negate the fact that more often than not, pain medications do delay labor.
For example, research shows women who opt for the epidural take two or three hours longer to push their babies out than women who forego this intervention.
Of course, there are situations in which women are so tense or anxious that they can’t relax. Sometimes these women opt for the epidural and find it helps them to relax. Then their body is able to begin to dilate. Still, labor would likely be faster if they were able to relax without drugs.
There is no significant difference among different pain relieving drugs. IV drugs and epidurals both contain opiates. These drugs interfere with natural oxytocin production and increase the need for Cesarean sections, too.
11 They Tense Up
The body is amazing thing. It is biologically wired to cope with childbirth and knows what to do far better than any birthing book or well-meaning friend. Allowing it to do what it’s meant to do is hard, though. Women want to feel in control, and many fail to understand that being in control of childbirth means having the courage to let your body take over.
Much like trying to sand a plank of wood against the grain, going against the natural process of labor makes everything harder than it has to be and often doesn’t produce the result that was desired. Many women are unaware that the cervix is actually biologically linked to the muscles in the face and jaw.
When the face and jaw are relaxed, so is the pelvis. When the mouth is loose and open, the cervix can follow suit. The whole female body truly does work together to birth babies when it is left alone to do so.
10 Artificially Rupturing The Membranes
AROM — short for artificial rupture of the membranes — is often sought to help speed up the labor process. The thing is, this works best when the membranes rupture on their own. Breaking the bag of waters artificially involves allowing the doctor to insert a hook-like device called an amnihook into the cervix to puncture the amniotic sac.
When the body isn’t prepared for the amniotic sac to rupture, it may intensify contractions too early and cause fetal distress. In many of these cases, a Cesarean section must then be performed. AROM also increases the risk of infection.
In addition, any time an intervention is employed, it increases the risk of needing other interventions. AROM also increases the risk of cord prolapse; it will occur in 1 out of every 300 AROM procedures. When placental blood vessels are punctured, fetal blood loss can also occur.
9 Using Pitocin To Move Things Along
Sometimes, Pitocin is unavoidable. Emphasis on sometimes. Often, it is pushed on moms-to-be by doctors who are eager to get their babies delivered on schedule. In an ideal world, it would be great for doctors to have births that start at 9AM and leave them free to go home for dinnertime.
In the real world, babies are born when they are ready. Moms in the know understand this process.
When the baby’s lungs are mature, they release surfactant — and that releases oxytocin that sparks the start of labor. If a medical situation presents that requires induction, Pitocin is surely a safer option than AROM and far more recommended. Still, it can slow things down.
Opting out of other drugs can help. Pitocin can cause contractions to be much more intense than they would be without the synthetic induction med. Still, it delays labor most of the time.
8 Frequent Cervical Checks
Throughout the history of the entertainment industry and among women everywhere, dilation and the progression of centimeters has been heavily discussed. Many women recall at what point during their labors things got tough by how dilated they were at the time.
Here’s the thing with dilation: it’s totally subjective. A male doctor will large hands is going to measure dilation differently than a petite female nurse with small hands.
Cervical checks actually aren’t necessary at all during labor if you’ve got a provider on your side that really knows what they’re doing and a mom that is willing to trust her body. Frequent cervical checks during labor is linked to greater chance of infection, premature rupture of membranes, and delaying labor.
Much of this is psychological, too. Women who are told by the nurse that they’re 6cm aren’t very happy when the doctor comes in and says they’re 4cm. More and more women are refusing cervical checks now, and for good reason.
7 Getting Dehydrated
Dehydration leads many women to have more severe contractions and can actually cause inflammation. This inflammation can cause the cervix to swell. In many cases, this swelling can make the cervical lip difficult to bypass during a vaginal birth.
While you might have heard dehydration can cause contractions and preterm labor, it can also cause contractions that are already flowing to come to a screeching halt. Babies are more likely to experience fetal distress in these circumstances, too.
This is one reason that having a saline lock in place during labor may not be the worst idea in the world. If you think you might experience nausea and vomiting or frequent bowel movements during labor, it might actually be wise to ask for some extra fluids.
Contrary to popular belief that women should not — or are not allowed to — have food or fluids during labor, they need them! You need energy to get through this marathon. Don’t skimp on the protein and water.
6 Being Afraid
Fear produces adrenaline, as does anxiety. It’s normal to be scared of childbirth — especially if it’s your first baby. You don’t know what to expect. Perhaps you’ve gone through it before and it was a less than lovely experience.
Know that history does not have to repeat itself where childbirth is concerned. Each pregnancy is different and usually labors are, too. No one is saying don’t be afraid. If you feel scared, then feel scared, but birth with confidence anyway.
Use the time over the next 9 or so months to immerse yourself in research. Looking into the natural side of childbirth is an amazing way to prepare yourself to endure it.
Even if you go the way of medication, understand the chemical and biologic process of childbirth above and beyond the stages of labor and what they teach you in childbirth classes can help to keep you feeling calm and empowered during labor.
That’s what you’ll need to combat the fear and make sure that adrenaline doesn’t take over and put you into fight or flight mode. That is what will slow labor down.
5 Having A Breech Baby
Part of this goes back to why you shouldn’t skip out on your trips to the chiropractor. Babies can settle into all kinds of crazy positions as they’re floating around in the womb. Some will opt for transverse — lying horizontally across their mother’s abdomen.
Just 1 percent of babies actually stay this way by the time moms are in labor. So, don’t get too worried if you’re feeling all those kicks and punches in your sides.
Some babies will present sunny-side up; others will be breech. In these cases, vaginal births are still possible with the right provider in tow. However, these labors generally take longer and can be more painful. Back labor is also more likely when position isn’t ideal.
For the best birth outcome, moms want a baby that settles into the left occiput anterior position where they are head down with their back facing the front left side of mom’s midsection.
4 Believing She's Too Small To Birth Naturally
A lot of moms worry about cephalopelvic disproportion, which is silly because it is actually quite rare. Perhaps not so silly, though, is how common it is for doctors to scare women into unnecessary inductions and Cesareans by telling them they are too small to birth their babies.
Often, these doctors are relying on ultrasound technology for estimated measurements. The problem with this is that ultrasound is known to be off by as much as two pounds in either direction. In addition, measurements are only as good as the technician taking them; they are very subjective.
Moms can open the pelvis even wider by squatting for active labor. This position opens the pelvic capacity up and expands the area by 30 percent. While about 1 in 3 Cesareans are performed because of CPD, studies show 65 percent of moms who undergo these surgeries because of such go on to deliver babies vaginally afterward — often babies that are larger than the one that was said to present with CPD.
3 Having Weak Contractions
Sometimes, contractions just don’t take off like they’re supposed to. The reasoning behind this isn’t fully understood and likely isn’t the same in every situation. In some cases, it might be due to hormonal imbalance that impacts the flow of oxytocin during labor.
In other instances, it could be uterine fibroids that get in the way during contracting. Some women also have too much amniotic fluid. This condition — known as hydramnios — can cause distention when contractions start.
In short, they just may not be powerful enough to get the job done. What is their job? To push that baby downward. Without effective contractions, doctors may start using terms like “failure to progress”, because without effective contractions, you won’t dilate well and baby won’t move down the birth canal.
If it is determined that those contractions are doing nothing more than wearing you out, it might be worth weighing the advantages of ramping them up. Natural methods like nipple stimulation can be tried first, but Pitocin may be needed in some cases.
2 Progressing Slowly
If the cervix stops dilating and doesn’t progress at all for at least two hours, doctors often just diagnose their patient with cervical dystocia. This is nothing more than terminology though. Women progress at different rates of speed.
Most of the time, cervical dystocia occurs due to fibrosis from previous issues, such as having a cone biopsy or having tumors, fibroids or polyps on the cervix.
Sometimes this is referred to as obstructed labor. Regardless of the cause, cervical dystocia is the leading cause of Cesarean sections in the United States. Cut-offs and time limits are imposed on women out of routine with little regard for evidence-based care.
If there is no sign of fetal distress, women must be armed with the knowledge that cervical dystocia is not a reason to immediately subject themselves to a C-section. It may delay labor, but other measures noted here, such as relaxation and movement, should be taken first to try to get things going again.
1 Feeling Stressed
Much like fear and adrenaline slow down labor, stress does the same by way of cortisol. This stress hormone is so potent that is can actually cause a woman to regress in dilation. Many women are unaware that this can happen. Stress is often the culprit.
When a woman isn’t relaxed, she isn’t able to relinquish control of labor unto her body. Cortisol does a lot more than raising blood pressure and causes us to feel frazzled.
When this hormone floods the body, it interacts with the oxytocin that is keeping labor going and can almost drowned it out in some cases. Cortisol also causes the body to produce insulin.
An overage of insulin then causes blood sugar imbalances that can leave moms-to-be feeling worn out and depleted of all energy they need for childbirth. It is thought that cortisol levels are naturally much lower at home than in high-stress environments, like hospitals, and this may be part of the reason why home births statistically have more favorable outcomes than hospital births.