Prolonged Labor: Failure to Progress

Pregnant woman having a prolonged labor.

Prolonged labor, also known as failure to progress, occurs when labor lasts for approximately 20 hours or more if you are a first-time mother, and 14 hours or more if you have previously given birth. A prolonged latent phase happens during the first stage of labor, can be exhausting and emotionally draining, but  rarely leads to complications. However, prolonged labor during the active phase of giving birth, can be cause for concern. If you experience failure to progress, your healthcare provider will begin running tests to determine the cause.

What are the causes of prolonged labor or failure to progress?

There are a number of possible causes of prolonged labor. During the latent phase, slow effacement of the cervix can cause labor time to increase. During the active phase, if the baby is too large, the birthing canal is too small, or the woman’s pelvis is too small, delivery can take longer or a failure to progress. Carrying multiples may also lead to prolonged labor, as might weak uterine contractions, or an incorrect position of the baby. Research has also linked prolonged labor or failure to progress to psychological factors, such as worry, stress, or fear. Additionally, certain pain medications can slow or weaken your contractions.

What are some solutions to prolonged labor or failure to progress ?

Although some causes of prolonged labor may require medical intervention, there are some steps you can take to ease your way. If you are failing to progress during the latent phase, the best thing to do is relax and wait while the cervix ripens. Take a walk, sleep, or take a warm bath. If drugs are slowing your contractions, you may need to simply wait until they are flushed from your body. Sometimes changing positions may help the process along; lay on your other side, stand, walk, or squat.

Prolonged Labor and Cesarean Sections

Also called a C-section, the Cesarean section may be the answer to several of the issues that cause prolonged labor. Nearly a third of C-sections are performed due to failure to progress. If your baby is turned the wrong way, the head is too large to fit through the pelvis, or the baby’s head is in the wrong position, a Cesarean birth might be the best choice to avoid further complications. C-sections are also very common for births of multiples. Nearly half of twin births are done through C-section, while approximately 90% of triplets are born using C-sections. Although C-sections are a major surgery, and there are risks associated with the procedure, it is considered fairly safe. This procedure is most often employed to prevent more serious birth complications, and it is generally considered worth the risk to avoid further critical labor issues.

Compiled from the following Resources:

Erickson, M. (1976). The relationship between psychological variables and specific complications of pregnancy, labor, and delivery. Journal of Psychosomatic Research, 20(3), 207-210.

Harms, R. (2004). Mayo Clinic guide to a healthy pregnancy. New York: HarperResource.

Kapp, F., Hornstein, S., & Graham, V. (1963). Some psychologic factors in prolonged labor due to inefficient uterine action. Comprehensive Psychiatry, 4(1), 9-18.

Prolonged Labor: Causes and Treatment. (2012, January 24). Retrieved August 13, 2014, from http://www.webmd.com/baby/guide/prolonged-labor-causes-treatments

Simkin, P. (1991). Pregnancy, childbirth, and the newborn: The complete guide (Revised/Expanded ed.). Minnetonka, Minn.: Meadowbrook Press ;.