Labor Progressing Slowly – Risks Diagnosis And Treatment of Prolonged Labor

Labor Progressing Slowly – Risks Diagnosis And Treatment of Prolonged Labor

Giving birth is a unique experience for a woman. Especially, when it’s a vaginal delivery the ordeal of pain and suffering can’t be expressed in words. During labor, sometimes the baby comes out very fast but in other cases, this bundle of joy can create problems with very slow progress.

Labor in terms of delivery is referred to as a series of strong and repeated muscle contractions. This is mostly felt in the lower back and in the area of the belly. The contractions help dilate or widen the opening to the vagina (called cervix). This contraction helps the baby come out of the womb or uterus into the birth canal. 

The labor period of women who are first time pregnant lasts on an average of 12-18 hours. While those giving birth to second or third time will experience about half of that time. 

What is prolonged labor?

At times, labor stalls or fails to progress adequately. This is known as prolonged labor or “failure to progress”. Prolonged labor can be calculated by the stage of the labor or whether the cervix has widened and opened properly during this period.

If the baby does not come out or not born after approximately 20 hours of contractions, then it’s a case of prolonged labor. This duration could be 14 hours for the second time mothers. Other experts say prolonged labor for the first mother occurs after 18-24 hours.

For pregnant women who are carrying multiple babies, prolonged labor lasts 16 hours or more. The slow labor according to doctors is called as ‘prolonged latent labor’. 

Why prolonged labor occurs?

There could be several reasons for labor progressing slowly. These are:

  • The baby is big and unable to move through the birth canal
  • Birth canal too small for the baby
  • Abnormal position or breech position of the baby
  • Weak contractions

Risks of prolonged labor

If the labor process is too slow, it increases the chances of cesarean delivery. Labor taking too long can be dangerous for the well-being of the baby. It may result in:

  • Low oxygen levels in baby
  • Uterine infection
  • Entering of Abnormal substances in the amniotic fluid
  • Abnormal heart rhythm in the baby

Diagnosis - What happens if labor goes too slowly?

One thing that every woman wants is that the labor goes fast with swift delivery. But this wish is often shattered if labor goes very slow. In this case, one should not lose patience and trust the doctor and nurses who will be closely monitoring the health of both every moment. 

The team will be checking:

  • How often you are experiencing contractions
  • The intensity of your contractions

To determine these, following tests may be conducted:

  1. Intrauterine Pressure Catheter Placement (IUPC) – The doctor will place a tiny straw monitor in the womb or amniotic space beside the baby to know the pressure, duration, frequency and strength of contractions. If the doctor sees that the contractions are not strong enough, he may consider adding Pitocin, a medicine used for inducing labor.
  2. Continuous electronic fetal monitoring (EFM) – This special equipment measures the baby's heart rate by placing two elastic belts on your belly. One sensor reflects sound waves to the monitor, the other measures contractions.

Treatment of prolonged labor

The first thing that the doctor would advise you in case of slow labor is just to relax and rest for a while. In some other cases, medicines are given to lessen labor pains and help you relax. You might feel like changing the position to feel a bit comfortable.

Additional treatment procedure will be devised based on the labor progression.

  • If the baby already entered the birth canal, the team might use special equipment called forceps or a vacuum device to pull the baby out.
  • If the doctor is unable to feel strong contractions via IUPC, then he might give oxytocin (Pitocin). This medicine increases contractions making them more intense. But if you are contracting enough and the labor is still progressing slowly or stalled, you might need a c-section.
  • In case of macrosomic or large sized baby, cesarean or c-section will be performed.

In a recent study, researchers have found that administering glucose supplements, especially in case of first birth, can cut the labor time by a good margin. According to this study, led by Josianne Pare, University of Sherbrooke in Quebec, Canada, glucose supplementation can improve muscle performance and this could accelerate the process.

The study was done on 200 pregnant women who were randomly given either salt/water solution or glucose solution containing salt and water. The results showed that women who were given glucose solution, their labor time was shorter by whopping 76 minutes. However, there was no difference in the mode of delivery such as vaginal, cesarean, forceps, etc.

Labor is the time where close monitoring plays an important role. So believe your team of doctors and follow their instructions carefully during this herculean task.