Tuesday, September 21, 2021
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Understanding Slow Labour

This article has been REVIEWED by a physician

We use review ONLY where an article contains information that could be considered from a medical standpoint. The review ensures factual correctness from a medical standpoint only and in no way suggests that the article content is endorsed by the Reviewer or is the Reviewers own viewpoint.

Most women who are nearing the end of their pregnancies feel physically ready to deliver their baby. Some babies arrive quickly, whilst others take a little longer to make themselves known. Slow labour, which is also called prolonged or stalled labour, can take time and endurance.

Labour can slow for any number of reasons the commonest of which are that contractions are infrequent or ineffective, the baby isn’t in the streamlined position or the baby is too big for the mother’s pelvis. Once labour begins, your body may take some time before it is prepared to move into established labour. This is called the latent phase of labour when the contractions are softening and thinning the cervix. Even though a woman might be in active labour, the process can sometimes slow down or stall completely. Though this experience can be discouraging or even worrying, talking with your doctor before you go into labour can help allay any fears.

To better understand slow labour, here is a brief description of what happens during labour.

  • The signs of the latent phase of labour include passing the mucus plug known as a show, or contractions which are painful but not regular leading to softening and thinning of the cervix in preparation for the active stage of labour. This can happen over a few days

Labour begins when contractions cause your cervix to begin to open or dilate.

  • Once your cervix has opened to at least 4 cm and you are experiencing regular contractions, you are considered to have reached the point of established labour.
  • When your cervix is fully dilated, you may or may not begin to feel the urge to push as your baby begins to move down the birth canal. For many women, their baby arrives within three hours of the beginning of this stage of labour.

Labour can slow or stall despite the fact that contractions are still occurring. The reasons why a labour slows can involve many factors, like the position or size of the baby.

If you find your labour is slowing, it is understandable to feel concerned, and you may be getting physically exhausted. Here are some ways to cope with slow labour whilst also encouraging labour to progress:

  • Change your physical position with brief walks around the room or whilst sitting on a birthing ball. If you must lie in bed, you can change sides and lean forward. Leaning forward whilst standing, with support, can also be helpful.
  • Drink fluids or suck on ice chips to stay hydrated and keep your contractions as effective as possible.
  • Compassionate self-talk can ease the emotional pressure you may feel if your labour slows. Giving yourself gentle support and encouragement whilst also being patient with yourself can enable you to embrace the natural rhythms of your labour.
  • Request support and reassurance from your support network. Asking for what you need at this time can also relieve emotional pressure. Whether it’s a change to your environment, a comforting message, or a moment of peace, asking for what you need ensures that you feel some agency over the experience of labour.

Your doctor may recommend an oxytocin drip to improve the strength and frequency of contractions and to encourage the baby’s head to turn into the streamlined position. They may also recommend an epidural to help with the pain and to give you some rest.

If you are fully dilated and progress is slow, your doctor may recommend an assisted delivery such as the vacuum cup (Ventouse) or forceps delivery. Occasionally it’s necessary to do a caesarean section if labour isn’t progressing normally.

It is important to have discussed these possibilities at your parentcraft classes and with your doctor or midwife as part of your preparation for birth.

https://www.parents.com/pregnancy/giving-birth/labor-and-delivery/when-labor-stalls/

https://www.nhs.uk/pregnancy/labour-and-birth/what-happens/the-stages-of-labour-and-birth/

https://www.tommys.org/pregnancy-information/giving-birth/stages-labour

https://www.motherandchildhealth.com/pregnancy-birth/coping-with-slow-labor/

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about the reviewer

Dr Lisa Joels

MB ChB, MD, FRCOG, FHEA

OBSTETRICIAN & GYNAECOLOGIST

Dr Joels has 34 years’ experience in obstetrics and gynaecology including 19 years as a Consultant working in Swansea (2001-11) and subsequently at the Royal Devon & Exeter NHS Foundations Trust in the UK (2011-20). These are both University teaching hospitals, each having more than 4,000 deliveries a year and providing tertiary obstetric and neonatal services as well as gynaecological services to their local population.



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