Prolonged labor, also known as “failure to progress,” occurs when labor has stalled or moved slower than expected. It occurs when labor lasts about 20 hours or more if a woman gives birth for the first time and 14 hours or more if she has a second baby. Labor can be abnormally prolonged due to the contractions of the uterus. uterine, fetal or pelvic abnormalities.
There are a number of possible causes of prolonged labor such as –
• Slow cervical dilation – When the cervix isn’t dilating, labor cannot progress for the fetus to descend.
• Slow effacement – Effacement happens when the cervix thins during labor, and it prepares your body for delivery.
• Abnormal position of the baby – During labor, it is desired that the fetus be head down (vertex) rather than head up (breech) or sideways (transverse). Similarly, it is desired that the vertex fetus be head-down and facing your back.
• Small birth canal or narrow pelvis – This can halt a baby from passing through.
• Weak contractions – Pain medication that is given during labor can contribute to the weakening of uterine contractions.
• A large baby — Medically referred to as cephalopelvic disproportion, a large baby can have difficulty passing through the birth canal
Prolonged Labor Risks –
If your labor lasts longer than expected, and medical care isn’t given timely or appropriately, it could come out with the following problems –
• Lack of oxygen – When a fetus’ brain is deprived of oxygen, it can lead to long-term disabilities with speech and mobility, learning difficulties, autism, epilepsy, and cerebral palsy.
• Fetal distress – Signs of fetal distress may be difficult to detect, that is why it is necessary that your doctor’s properly monitor you and your baby for abnormal signs.
One thing that Mothers can notice is decreased fetal movement. Sometimes that occurs when the fetus is sleeping, and other times the decreased movement occurs when your fetus’ oxygen levels drop to dangerous levels. When it goes undetected, or it isn’t addressed immediately, the long-term effects could lead to hypoxic-ischemic encephalopathy — a type of permanent brain damage.
• Use of forceps/vacuum extraction – When labor isn’t progressing, doctors may make the decision to use forceps or vacuum extraction to assist with delivery.
However, when neither are used properly, there can be an increased risk of long-term damage to the baby, resulting in birth injuries such as –
° Cerebral palsy
° Bleeding on the brain or in the tissues above the brain due to the traction injuries due to the forces from the vacuum or forceps
° Skull fractures
° Brachial plexus injuries (paralysis to the arm), including Erbs palsy
How Is Prolonged Labor Treated?
• If labor is going slowly, you may be advised to just rest for a little while. Sometimes medicine is given to ease your labor pains which may help you relax. You may feel like changing your body position to become more comfortable.
Additional treatment depends on why your labor is going slowly.
• If the baby is already in the birth canal, the doctor or midwife may use special tools called forceps or a vacuum device to help pull the baby out through the vagina.
• If your doctor feels like you need more or stronger contractions, you may receive Pitocin (oxytocin). This medicine speeds up contractions and makes them stronger. If after your doctor feels like you are contracting enough and the labor is still stalled, you may need a C-section.
• If the baby is too big, or the medicine does not speed up delivery, you will need a C-section.
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