When Labor Stalls

Labor Stalls

Some people have labors that proceed in textbook fashion: contractions begin, grow stronger and closer together, and then after some pushing, baby is born. And while many labors loosely follow this general pattern, there are as many different experiences of labor as there are babies being born. Early labor—when contractions are often spaced out and may be just under a minute long—may last for many hours and a three-hour labor is as normal as one that lasts 30 hours.

Sometimes labor stalls in early labor or after you have already been in active labor—with cervical dilation of six centimeters and regular contractions—for a while, which is also sometimes called failure to progress or labor arrest. [1] Read on to learn about the reasons why labor might stall and things you can try to jumpstart it if it does.

Before true labor begins, you might experience prodromal or false labor, which could include the body’s practice for labor, Braxton Hicks contractions. Contractions starting and stopping is normal before true labor begins, so if you have not established a period of regular contractions yet, it’s likely you’re not in labor yet. If prodromal labor stops, it hasn’t technically stalled, though some things we will discuss below might help turn prodromal labor to true labor and it certainly will not hurt to try them.

In the early phase of labor, contractions come regularly, even if they are far apart at first, and feel different than the tightening of your uterus that is characteristic of Braxton Hicks contractions. Labor might stall in the early phase because baby is not in the optimal position, you leave your home and head to your place of birth (hospital or birth center), you stop moving, or you do not feel safe. [2] The ways to restart early labor focus on addressing these reasons labor might have paused.

If you were moving a lot in early labor, but had to stop to sit in the car to go to your place of birth or laid down to rest and labor paused, moving around might help it start up again. Movement can also help baby shift into a different position that may help labor progress. Walking, dancing, and climbing stairs are options that are almost always available. Another option is The Miles Circuit, a series of positions that take about 90 minutes to complete and can help give labor a boost. [3]

How you are feeling emotionally—if you are anxious or worried, for instance—can also put a damper on labor, which is another reason why leaving home to go to the hospital or birth center might slow your progress. [2] What if you’ve tried moving around and hydrating, but labor still hasn’t picked up again? Ask your partner, doula, and care providers for help making your labor space feel cozy and safe. You might want to turn down the lights, play soft music, ask for quiet time with your partner, or move into a smaller space like the shower, where you can also take advantage of the pain relief properties of water. Acupuncture and acupressure can also help early labor move forward.

If you experience labor arrest in the active phase or during pushing, some of the techniques above may still help. It is also possible that a medical intervention would work best to get your labor started again or to help your baby be born. The American College of Obstetricians and Gynecologists describes arrest of labor as lack of progress in cervical dilation and movement of baby downward after your water has broken and your cervix is dilated at least six centimeters. Sometimes if labor stalls and your bag of waters has not been broken, your care provider will offer to break it as a first option.

Another strategy to get labor moving includes receiving Pitocin—the synthetic version of oxytocin, the hormone that strengthens contractions during labor—through an intravenous line. Sometimes Pitocin helps contractions start again and labor progresses from there. It is also possible that pain you are experiencing has stopped your labor, in which case, receiving pain medication, perhaps in the form of an epidural, could help. In some cases, baby’s position or size or the size or shape of your pelvis may lead to labor stalling in the active phase or during pushing, and then the best option to help your baby be born is Cesarean section, a surgical birth.

It is normal to feel anxious about the possibility of labor stalling. In addition to the information here, you can always talk to your provider in advance of your birth about the strategies they use when labor stalls. Having more knowledge may help you know what to expect and feel less anxious.

References:

  1. American College of Obstetricians and Gynecologists, Safe Prevention of Primary Cesarean Delivery
  2. Lamaze International, What if my labor stalls?
  3. The Miles Circuit
Abby Olena
Dr. Abby Olena has a PhD in Biological Sciences from Vanderbilt University. She lives with her husband and daughter in North Carolina, where she writes about science and parenting, produces a conversational podcast, and teaches prenatal yoga.

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