Failure of progress

8 Natural & Effective Tips For a ‘Stalled’ Labour

If you’re birthing in a hospital and find that your labour reaches a plateau or stalls, unless you’re informed about what a stalled labour means and what you can do to help yourself, it can become a very anxious time.

Sooner or later, you will receive (increasing) pressure to accept a medical augmentation to hurry things along, for example, breaking your waters or using Syntocinon, which is the same drug used intravenously (in a drip) to induce labour, making it much more painful and intense. It can give you less of a rest between contractions, at a time when you’re probably already exhausted, and will greatly increase the likelihood of further medical procedures, particularly caesarean section.

Emotionally, you and/or your partner may also start to experience negative and disempowering thoughts, which can make matters even worse, for example: ‘My body doesn’t work’, ’I’m failing/a failure’, ’I’m just one of those women who can’t birth vaginally’, or ‘All this work, all for nothing.’ This in itself can set a labour back.

In the first stage of labour (contractions phase), some women will experience a plateau and some will not – there is nothing you have done wrong either way, it’s just one of those things that happens. The good news is, there is something you can do about it.

Firstly, you need to understand that there are several ways a doctor or midwife will medically evaluate and label the progress of your labour. This may include any of the following:

• Dilation (10cms being a fully dilated cervix, allowing for pushing)
• Effacement
• Strength of contractions (feeling your abdomen/electronic monitoring)
• Time between contractions
• Length of contractions
• Station
• Behaviour being displayed by the mother

Unfortunately for the birthing mother, none of these methods are reliable or foolproof, even for the most experienced carer – meaning she may end up with unnecessary interventions or tests based on those evaluations. This is especially the case when trying to assess how many centimetres dilated a woman is, for two main reasons:

1) They can’t see your cervix – they have to guess with two fingers inserted into your vagina. I’ve seen a midwife and a doctor give quite different measurements, hours apart, which greatly upset the mother. She felt like she had gone backwards from what the midwife had told her earlier. She was tired and now discouraged, anticipating the end and was closer than what the doctor had said based on his estimate.

2) One centimetre of dilation could take 10 minutes or it could take 2 hours – yet the labour could still be progressing in a healthy way. Doing an exam is not going to speed up your labour or change your progress, but it could end up slowing labour down and make you feel miserable in the process.

So there are two perfect reasons why these sorts of exams should be avoided, unless there is a genuine medical need! It doesn’t matter what ‘number’ you are… your baby WILL come out, no matter if you’re 2 or 10!!! You wont be pregnant forever.

Labour does not follow any hard or fast rules and can respond to so many different factors and influences. However, there is evidence that a plateau in labour is very normal and healthy – instead of failure to progress, it’s very much failure to wait.

So with that in mind, let’s see what you can do.

Go for a Walk / Get Up

Getting up and moving is a great way to encourage baby’s decent, which involves lots of shifting, wriggling and turning it’s way through your pelvis and behind your pubic bone. Movement on your part, especially walking and going up and down stairs, helps that shifting and moving. It also helps to put more pressure on the cervix to assist with dilation. If you can walk through a contraction, even better, but this can be a tricky feat especially later in labour!

Change the environment

Some questions you (or your support people) might like to consider are:

• Is the room too bright?
• Do you feel closed in or claustrophobic being stuck in a small room and need some fresh air?
• Is there too much stimulation/chatter/annoying noise going on?
• Do you need some privacy?
• Do you feel uncomfortable and/or are there a lack of labour aids?
• Is anyone making you feel uncomfortable or is someone there who you don’t want to be?

Sometimes things going on in your environment can raise your stress or adrenaline levels which can slow down or halt labour. Adrenaline reduces the amount of oxytocin (the labour hormone) in the body – you can’t have both as it’s a response your body creates to shut down your labour until you are in a ‘safe’ place again. Imagine a set of scales – one side up, one side down. High oxytocin requires low adrenaline. High adrenaline means low oxytocin… and you don’t want that in labour. If you are able to, get some fresh air, think about what you might need and consider asking for a different midwife if you’re having trouble relaxing around the one you have been assigned.

Change positions

Similar to the comments on walking, changing your position helps the baby to shift and move around to get into the right spot – help him wriggle on down! Being stationary in one position can slow things down and make things more uncomfortable for a birthing mother.

Nipple stimulation

Nipple stimulation produces oxytocin and can produce some strong effects, so you can try stimulating your nipples (including your areola, as a baby would when sucking) with your fingers, massaging one at a time. An alternate option is if you are still feeding a toddler, let him attach and the sucking action will do the same thing.

Massage the first nipple for 5 minutes (when there are no contractions), then wait to see what happens before doing more. It’s a good idea to take your mind off things by getting on with your usual duties than sitting and waiting for something to happen – so try and keep busy!

Once labour is well established again, stop the stimulation.

Sex/Orgasm

Orgasm produces oxytocin… so tap your man on the shoulder or DIY – because it could well help labour along, and let’s admit it, you’re not exactly going to suffer for trying!

Acupressure/Acupuncture

Acupressure can be learnt before labour, so you or your partner can work on acupressure points should you want to get labour moving. Alternately you can speak to an acupuncturist about the possibility of them supporting you at birth or attending your labour.

Debra Betts has put together a brilliant document on acupressure for pregnancy, labour and post birth, with solutions for all sorts of situations, from encouraging labour to vomiting and nausea in labour. You can download a copy here.

More information about this can be found in our Naturally Inducing Labour article.

Emotional Factors

This can be an unexpected thing to consider, but childbirth can bring about a big emotional upheaval for some people, anticipated or not. Perhaps you or your partner is really wanting a boy and you’re having a girl… perhaps you’re anxious about pushing baby out or are recalling a horror story from a friend… perhaps you have had someone close to you pass away recently… perhaps you feel scared worrying about what will happen after the birth, because the baby was unplanned and you or your partner are not sure how you feel about things.

At births I have supported, I have seen occasions where parents (or others) turn up unexpectedly and unannounced, asking to wait for the mother to birth – even where it was the mothers wishes for them not to be there. This happen and it can really set back a labour, requiring time to help the woman become focused and calm again – never anger a labouring woman!!! So perhaps you are worried this situation may occur and feel anxious for this reason. At the end of the day, there are just so many things that can mess with the process of labour when you mess with the mother’s right to privacy and safety.

Exploring any psychological reasons that may come up during your labour can be a huge help, ideally if you are aware of any before you give birth. It is common for women giving birth who have lost their own mothers tend to go through some strong emotions. In any case, it would be a good idea to seek counselling to help deal with how you feel to prevent events playing out in labour. If something does happen during labour, then hopefully you can find a midwife (or your doula or partner) you trust to let them know what’s going on.

Wait it out! Yes!