Prolonged labor is one of the most uncomfortable and overwhelming experiences that a pregnant woman who gives birth naturally goes through.
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What Is Considered Prolonged Labor?
Labor consists in a number of muscle contractions that helps the baby move from the uterus through the cervix. They help in dilating the cervix and, therefore, giving birth to the baby. Contractions are usually felt in the abdomen and lower back, and increase their intensity as labor progresses.
For a woman who gives birth for her first time, labor will last 12 to 18 hours. But for a woman who already gives birth, it`s half the time.
Prolonged labor, known as failure to progress as well, takes place when labor lasts for at least 20 hours if you are at your first pregnancy, and 14 hours if you already gave birth once at least. A prolonged latent phase occurs during the 1st stage of labor. It rarely ends with complications, but it can drain you emotionally and can be really exhausting.
Still, a real reason of concern can be prolonged labor during the active phase of labor. If this might happen, your doctor will start performing various investigations in order to determine the real cause.
What Is a Latent Phase of Labor?
The initial phase of labor is also known as the latent phase. It all begins when the woman starts feeling regular contractions, generally every 3 to 5 minutes for at least 1 hour (however, this may not always be the case). This type of contractions starts to soften and dilate the cervix gradually. This rather simple definition belies a process so complex that isn`t fully understood by today`s science.
What Are the Causes of Prolonged Labor?
There`re a series of possible causes that involve prolonged labor. A slow effacement of the cervix might cause labor time to increase during the latent phase. During the active phase, if the woman`s pelvis is too small, the baby is too large or the birth canal is too small, delivery might fail to progress or take longer.
Being pregnant with more than one baby might lead to prolonged labor as well, due to an improper position of the baby or weak contractions of the uterus. Studies have linked failure to progress to factors of psychological matter, like fear, concerns or stress. In addition, particular pain drugs may weaken or slow the contractions.
In conclusion, the most frequent causes of prolonged labor are:
- Abnormal fetal position.
- Uterine contractions too rare or weak to deliver the baby.
- The cervix isn`t dilated sufficiently.
- Vaginal canal too narrow.
- The baby is too big and cannot pass through the birth canal.
Signs & Symptoms of Prolonged Labor
- Labor takes more than 20 hours, depending on where it`s your first birth or not.
- Labor pains might be prolonged, severe and frequent at first, but later become mild and decrease as the muscles get tired.
- The pregnant woman seems distressed and exhausted; the mouth might be dry because of prolonged mouth breathing and dehydration might be present.
- Pain might be more at the body`s sides and back, radiating to the thighs and not from the uterus towards the abdomen. This occurs because of the prolonged and excessive pressure of the back`s ligaments and muscles.
- Pulse rate is frequently high because of stress, dehydration and exhaustion.
- The uterus seems tender when touched and doesn`t relax completely between each contraction.
- You may experience fetal distress.
- Your large intestines feel dilated and along both of the uterus`s sides as thick and large structures that seem full of air.
- Membranes might or might not break early. If proper antibiotics aren`t prescribed, there`s a risk for the baby getting infected in early rupture.
What Measures Do Doctors Take in Case of Prolonged Labor?
During labor, nurses will constantly measure your vital functions, dilation of the cervix, pulse of the baby and will monitor your health state, so there won`t be any complications and not be needed to perform a C-section.
When entering in prolonged labor, doctors start taking measures to speed up the process of delivery, depending on the cause. If the contractions occur rarely or are too weak in intensity, doctors might administer oxytocin, a hormone that increases the intensity and number of contractions.
If the baby is already in the birth canal, but you cannot seem to push him further to expel him, doctors will start using the forceps or the vacuum cleaner to move him on the birth canal towards outside.
For the cervical dilation, doctors will administer prostaglandins, which have the role of thinning and opening the cervix, thus preparing for birth. If the baby is too big or doctors don`t succeed in identify the cause of prolonged labor, they`ll resort to Caesarean birth as a measure of emergency. – Learn more info!
The longer labor lasts, the higher is the risk for the baby to be affected. Among the most common complications that may occur, there are:
- Hypoxia (lack of air or decreased concentration of oxygen in the bloodstream).
- Irregular pulse.
- Leakage of unusual substances in the amniotic liquid.
Dangers of Prolonged Labor
Dangers that involve the mother:
- Postpartum bleeding.
- Intrauterine infections.
- Postpartum infections.
- Postpartum infection.
Dangers that involve the fetus:
- Intracranial bleeding.
- Risks for the baby developing injuries permanently on the long term, like hypoxic-ischemic encephalopathy or cerebral palsy.
- Fetal distress because of low amounts of oxygen reaching the fetus.
- Increased changes of Caesarean birth or use of vacuum extractors or forceps.
To try and prevent prolonged labor, you could do any of the following:
- Get up from bed and walk around. This movement may increase the number of contractions.
- Go to the toilet – your full bladder may slow labor and prevent your baby from descending through the birth canal.
- Make a warm bath in a birth tub! This will most likely reduce the necessity of using drugs to trigger the birth of your baby.
- Try acupuncture or hypnosis.
Here are a few steps to help you relax and successfully face a prolonged labor:
- Use relaxation and breathing methods if you start feeling tense.
- Ask your partner to massage your back and legs while you sit on a chair.
- Listen to soft and relaxing music to calm down.
- Eat or drink something if you feel the need – a little snack, some fried bread and isotonic water can help you a lot.
- Change your position – later during labor you won`t be able to move too much, but the midwife will be able to help you find a position that is more comfortable.
- Move the hips and bend towards the front, like if you would play the piano, to help your uterus push the baby through the cervix.
- Talk to your midwife about what`s happening – you`ll feel a lot more relaxed if you feel things are under control.
- If the medical staff is busy and the midwife takes care of another pregnant woman, ask if a student in practice of any other person can join to offer you support.