Prolonged Labor

Childbirth is a unique experience for every woman, whether you're a first-time mom or a longtime parent. Sometimes, the baby comes really fast. Other times, well, not so fast. How quickly your bundle of joy arrives depends on many things, including how fast something called labor is happening.

Labor is a series of intense, repeated muscle contractions. The contractions help push the baby out of the uterus (womb) and into the birth canal.

You will probably feel the contractions in the lower back and belly area. This is called labor pains. The contractions help dilate (widen) the opening to the vagina (called the cervix). This allows the baby to move out of your body and be born.

First-time moms are usually in labor for about 12 to 18 hours, on average. If you've had a baby before, labor usually goes more quickly, usually about half that amount of time.

What Is Prolonged Labor?

Sometimes, labor stalls or occurs much too slowly. Prolonged labor may also be referred to as "failure to progress."

Prolonged labor can be determined by labor stage and whether the cervix has thinned and opened appropriately during labor. If your baby is not born after approximately 20 hours of regular contractions, you are likely to be in prolonged labor. Some health experts may say it occurs after 18 to 24 hours.

If you are carrying twins or more, prolonged labor is labor that lasts more than 16 hours.

Your doctor may refer to slow labor as "prolonged latent labor."

Prolonged labor may happen if:

  • The baby is very big and cannot move through the birth canal.
  • The baby is in an abnormal position. Normally, the baby is head-down facing your back.
  • The birth canal is too small for the baby to move through.
  • Your contractions are very weak.

What Happens if Labor Goes Too Slowly?

Most women dream of a fast labor and swift delivery. But if your labor seems to be going very slowly, take comfort in knowing that your doctor, nurse, or midwife will closely monitor you and your baby for any problems during this time.

Continued

The medical team will check:

  • How often you have contractions.
  • The strength of your contractions.

The following tests will be done:

  • Intrauterine Pressure Catheter Placement(IUPC) - a tiny straw monitor is placed into the womb beside the baby that not only lets your doctor know when a contraction is occurring, but how strong the contractions are. If your doctor does not feel like the contractions are strong enough, at this point is when they may consider adding pitcoin.
  • Continuous electronic fetal monitoring (EFM) to measure the baby's heart rate.

How Is Prolonged Labor Treated?

If your labor is going slowly, you may be advised to just rest for a little while. Sometimes medicine is given to ease your labor pains and help you relax. You may feel like changing your body position to become more comfortable.

Additional treatment depends on why your labor is going slowly.

If the baby is already in the birth canal, the doctor or midwife may use special tools called forceps or a vacuum device to help pull the baby out through the vagina.

If your doctor feels like you need more or stronger contractions, you may receive Pitocin (oxytocin). This medicine speeds up contractions and makes them stronger. If after your doctor feels like you are contracting enough and the labor is still stalled, you may need a C-section.

If the baby is too big, or the medicine does not speed up delivery, you will need a C-section.

Risks of Prolonged Labor

Prolonged labor increases the chances that you will need a C-section.

Labor that takes too long can be dangerous to the baby. It may cause:

  • low oxygen levels for the baby
  • abnormal heart rhythm in the baby
  • abnormal substances in the amniotic fluid
  • uterine infection

If the baby is in distress, you will need an emergency delivery. This is the time where close monitoring is important to the health of you and your baby.

WebMD Medical Reference Reviewed by Traci C. Johnson, MD, FACOG on August 04, 2014

Sources

SOURCES:

Merck Manual Home Edition web site: "Labor: Normal Labor and Delivery."

Rakel, R.E., ed. Textbook of Family Medicine, 8th ed., Saunders Elsevier, 2011.

Ratcliffe, S.D., Baxley, E.G., Cline, M.K., Sakornbut, E.L., eds. Family Medicine Obstetrics, 3rd ed., Elsevier Mosby, 2008.

World Health Organization web site: "Amniotomy for Shortening Spontaneous Labour."

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