Prolonged Labor: Failure To Progress

Prolonged Labor Failure To Progress

The long wait (of nine months) is over and now you are finally ready for the big event. The ride to the hospital may be filled with a mix of emotions for every mom-to-be. It can be one of excitement, nervousness, overwhelm, and of course panic. Every mom knows they are about to run a marathon in the labor room. But what if it takes longer than you expected?

What Is Prolonged Labor?

What Is Prolonged Labor

Prolonged labor is when labor does not progress as expected. In other words, failure to progress. According to the American Pregnancy Association, if the labor lasts for more than 20 hours for a first-time delivery, it is known as prolonged labor. For a woman who has previously given birth, prolonged labor is when the labor exceeds 14 hours. Studies show that failure to progress affects about 8% of women during labor for a variety of reasons.

The time when prolonged labor occurs determines if it will lead to a complication or not during delivery. Generally, there is a lower risk of complications if it occurs during the early or latent phase of labor. However, if the labor does not progress during the active phase, it can lead to complications for the mom and the baby. In such cases, medical intervention and assessment may be needed.

During labor, complications may arise that require immediate attention. The birthing process is not as straightforward as we believe it to be. Labor complications may occur at any stage. There are several reasons which contribute to complications during the birthing process such as the mother’s age, if the mother had a C-section for previous births, or if the woman is pregnant for longer than 42 weeks (1).

During a normal delivery, once your cervix is dilated enough, your baby passes through your cervix and pelvis. This trip through the birth canal may not be a smooth one for some babies if the mother is having prolonged labor. During labor, the baby’s head is the first thing that should ideally pass through the cervix. The pressure from the head will encourage the cervix to open up for the birthing process. Though the safest way is when the baby’s face is turned towards the mother’s back, there are several cases where the baby can turn in a different position during labor (2):

Face Presentation

  • It is when the neck of the baby is hyperextended.

Breech Presentation

  • It is when the baby’s bum or feet are in the position to be delivered first.

Shoulder Presentation

  • When the baby is curled up with the arm, shoulder, or trunk against the mom’s pelvis.

Your doctor may try redirecting your baby to an ideal position for safe delivery so that the head appears first in the birth canal. If it does not work, they may start thinking of other options. The doctors and nurses at the hospital will also be monitoring your baby’s heart rate and labor contractions. If the baby seems to be distressed, they may perform a C-section or give medications to speed up the labor process.

Here are some other reasons which contribute to prolonged labor (3):

  • Delay in the dilation of the cervix
  • A large baby
  • Delivery of twins or multiple babies
  • Fear, stress, worry and other emotional factors
  • Slow effacement
  • Smaller pelvis or birth canal
What Is Prolonged Labor1

Taking pain medications can also slow down or weaken the uterine contractions (4). During the early stage of labor, if the labor is not progressing as expected, your doctor may advise you to relax and wait for some time. The American Pregnancy Association recommends women to take a warm bath, go for a short walk, or sleep for a while if there is a failure to progress. Labor inducing medications or doing a cesarian delivery are only considered during the later stages of labor.

So, if the labor does not progress as you expected, the first thing that you should do is relax and wait. It’s important to trust your doctor and not stress yourself during this time. Your doctor will find a safe way to deliver the baby after monitoring the health of both you and the baby.

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