Red Light, Green Light – A Quiz on Getting the Best Care

Are you getting the best prenatal care from your provider (midwife, OB, or family doctor)? Take this “red light, green light” quiz to find out. Red light indicates care that is not evidence based or respectful of your choices. Yellow light indicates care that should make you question your provider further to see if she is the best fit. Green light indicates great care!

New Medical Guidelines Released to Prevent Cesareans

Earlier this week, the American Congress of Obstetricians and Gynecologists (ACOG) along with the Society for Maternal-Fetal Medicine (SMFM) released a joint Obstetric Care Consensus: Safe Prevention of the Primary Cesarean Delivery, in response to rapidly rising first-time cesarean birth rates that have shown no improvement in the death rates for moms or babies. (Complete details on the consensus can be found on ACOG’s website.) In the statement, the two groups put forth several new recommendations that propose to help prevent the first cesarean for women. If you are pregnant, you can use these new guidelines as a conversation starter during a prenatal appointment — find out how these new suggestions measure against your care provider’s routine practices. A sample summary of the recommendations is below.

A long first stage of labor — more than 20 hours in first-time moms — should not be cause for a cesarean. Many women are put on a time clock to dilate to 10cm, when in reality, a long labor alone should not be cause for a cesarean. If you hear statements like, “Your labor has stalled,” “You are not progressing,” or “Failure to progress,” followed by a recommendation for cesarean, ask: “Is my baby OK? Am I OK? What’s the risk in waiting or doing nothing right now? (or, what’s the alternative?)”

First-time moms should be permitted to push for at least 3 hours (2 hours for second-time moms) before recommending a cesarean. Unlike what Hollywood and The Baby Story show us, pushing can take a while. It’s important for moms to be given enough time to push out their baby, as long as mom and baby are both doing well.

Because induction raises the risk of cesarean, it should not be performed before 41 weeks unless medically indicated. Yes, 41 weeks! Allowing  baby enough time to continue developing and for your body to gear up for labor will give you the best chance of having a healthy mom and baby.

Ultrasounds performed late in pregnancy to determine your baby’s weight should be used only if there is clear indication, as these ultrasounds are linked to increased rate of cesarean for a “big baby,” which is rarely a good reason for cesarean. Ultrasounds have been shown, time and again, to be off by up to (or more than) a pound in either direction. If cesarean is suggested because your baby is estimated to be too big — get a second opinion from a care provider in another practice.

Continuous labor support — like that provided from a doula — is “one of the most effective tools” in improving birth outcomes. Good labor support is not just a “nice to have,” but a key component to improving your care during birth. Lamaze has known this for quite some time — check out our Healthy Care Practice number 3, “Bring a loved one, friend or doula for continuous support.

Being pregnant with twins does not automatically mean a cesarean, if twin A is in a head-down position for birth — even if the second twin is not head down. Vaginal birth for twin mamas — it IS possible!

Baby’s position in labor should be determined — especially if there are problems with baby moving down the birth canal — and if possible, an attempt should be made to manually re-position baby before suggesting a cesarean. A posterior baby (where baby faces toward your front instead of your back)  can cause problems in labor. Often, a baby will correct its position before birth, but not always, and this can cause issues. If you suspect an issue with your baby’s position during labor, mention it to your care provider. You can ask for ultrasound in labor to verify. Ask for help with trying to get baby in a better position for birth.

Childbirth Challenges

The following and several more great resources can be found at Lamaze.org/PushForYourBaby

Every pregnant mom wants a healthy baby, but common maternity practices may actually make it harder to have a safe and healthy birth.

Many interventions may seem like they would make childbirth easier. But, did you know that some of the care that pregnant women routinely receive can have unintended consequences and potentially make birth more difficult and less safe?

Here is the straight scoop on some common interventions. This information, and what you learn in a Lamaze class, can help you partner with your care provider to have the best birth day possible for you and your baby.

Epidurals

Let’s be honest. Most of us would love to avoid the pain of labor and birth. But, epidurals have both “pros” and “cons.” We already know the good part – a reduction in pain for you. But there’s less talk about the downside. It’s important to know that epidurals can set the stage for slower labor, more difficult pushing and dangerous blood pressure changes all factors that can lead to a C-section.

Women don’t always get support for exploring other, more natural pain relief options like movementfocused breathing, or a warm tub or massage (ahhhh!) to keep pain in check. So, weigh the risks and benefits before agreeing to an epidural – it’s an important step in making this personal decision.

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Overuse of C-Sections

Cesarean surgery can save lives, plain and simple. But, it’s pretty major surgery, and like any other surgery, it carries risks for you and your baby. So, there should be a really good medical reason to use it, right?

It’s sad to say, but more and more babies are being delivered by cesarean, even when there’s not a good medical reason to do so. In the United States, about one in three women who give birth will end up in the operating room.

Some women are told they are too overweight, too short or too old for vaginal delivery. Others are told their babies are too big or coming out too slowly. Women who have already delivered a baby by cesarean often are told that a vaginal birth after cesarean (VBAC) is off-limits and another cesarean is their only option. Many of these reasons sound like good medical thinking, but aren’t actually supported by the research.

To help spot a cesarean you might not need, be prepared to ask your care provider questions like: “Can we wait a little longer?”, “Is my baby in any immediate danger?” and “What are the risks if I proceed with a C-section, and those if I don’t?”

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Induced Labor

An increasing number of hospitals are cracking down on inductions, and for good reason. Artificially starting labor may be good for a care provider juggling a busy calendar, or your mother-in-law who wants to book her plane tickets, but it can make labor harder and more painful for women, and stress babies and jeopardize their health. Studies have consistently shown that the risk of having a C-section for first time moms nearly doubles with induction. It also increases your baby’s chance of being born premature. That’s because due dates aren’t an exact science. Even if you and your care provider are positive about your dates, every baby matures at a different rate. Inducing labor can mean your baby is born before he or she is ready.

Aside from the risks of induction, there are specific benefits to letting labor start on its own. During the last part of your pregnancy, your baby’s lungs mature and get ready to breathe. He or she puts on a protective layer of fat, and develops critical brain function through 41 weeks of pregnancy. Cutting the pregnancy short can be tough on your baby.

Before going through with an induction, tell everyone to hold their horses, and take time to learn more about benefits of letting labor start on its own.

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The American Congress of Obstetricians and Gynecologists, as well as theSociety of Obstetricians and Gynaecologists recommends listening to your baby’s heartbeat at key points in your labor for low risk women.

Electronic Fetal Monitoring (EFM)

There isn’t a mom on the planet who wouldn’t love a way to monitor every moment of her baby’s in utero existence. We all want to know our babies are doing ok. Using the same thinking, most care providers will monitor you baby’s every heartbeat during labor using electronic fetal monitoring, or EFM. It’s worn like a belt around your belly, and as long as you don’t move, it will record every heartbeat on a little strip of paper. Your care provider will watch the monitor and that little strip of paper for signs of trouble.

Sounds great, right? Well, there’s a catch, actually, three big catches.

  1. It doesn’t work. It’s natural to think that using EFM would help care providers spot babies who are in trouble, but every study that’s ever been done has shown the same thing. Using EFM doesn’t help improve the health and well-being of babies.
  2. EFM can lie. Well, not on purpose, but studies show that EFM can frequently give a false signal that a baby is in trouble. This means an emergency cesarean for mom, even though baby is perfectly happy and healthy.
  3. EFM confines pregnant women to bed. The best way to move your baby OUT is to get yourself up and moving. If you’re stuck in bed, you’re not able to help your baby on that journey.

What’s the alternative? Studies show that a baby’s heart rate can be monitored just as safely with a nurse, doctor or midwife regularly checking in to listen at key points in your labor with a Doppler.

Talk with your health care provider about using intermittent listening, so you can move freely, relax between contractions, and avoid the anxiety that comes with being tied to a machine. Keep in mind that if you have a medical complication, if your labor is induced or sped up artificially, if you have an epidural, or if a problem develops during labor, you will likely need continuous EFM. Otherwise, it can be safer and healthier to have intermittent monitoring.

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Restricting Movement During Labor & Pushing

In contrast to what you see in movies and on TV, lying on your back in a hospital bed is not the only way to give birth! In fact, walking, moving around and changing positions throughout labor makes the birth of your baby easier. Movement is the best way for you to use gravity to help your baby move down the birth canal and through your pelvic bones. Staying upright actually increases the size of your pelvis to make it easier for your baby to fit and rotate as necessary.

When it comes time to push, staying off your back and pushing with your natural urges can be key to making it as easy as possible on you and your baby. Be wary of anyone trying to “direct” your pushing. Nobody should be counting for you or telling you to hold your breath. It increases the risk of pelvic floor damage and actually can deprive your baby of oxygen! Keep in mind that if you have an epidural or continuous EFM, this will drastically restrict your movement during labor.

Learn more about how movement in labor, as well as pushing upright and with your natural urges, can improve your chances of a healthy, safe birth.

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Restricting Eating and Drinking in Labor

They don’t call it labor for nothing! For many women, labor is a physically intense experience that puts many demands on the body. Unfortunately, women are routinely restricted from eating or drinking in labor, which can mean running out of energy when it’s needed it most. The restrictions come out of concerns that, if a woman ends up needing surgery, she should have an empty stomach. But research shows that modern anesthesia techniques make complications from food in the stomach exceedingly rare, and that laboring women can safely eat and drink in labor. So, be prepared. Make a point of discussing this with your care provider and be sure you’re able to get the nourishment you need to do the hard work for labor.

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Adequate Support

If you traveled to an exotic country and didn’t speak the language, you probably would consider hiring a tour guide to ensure your vacation was safe and fun. More and more, women are recognizing the same need in labor. Research shows that women who have continuous labor support from a friend, family member, and especially, the help of a professional labor assistant known as a “doula,” have easier and slightly shorter labors.

Many women count on having a nurse by their side to provide this support. Sometimes that happens, but most labor nurses are caring for several women at the same time and don’t have the time to provide contraction-by-contraction support. Dads often are expected to fill this role, but they are new to the process, too, and often need cues on how to best be supportive to their laboring partners.

So, think through interviewing a doula or consider whether you know someone who is especially knowledgeable about childbirth. Having someone you trust by your side can help you manage your labor, support good decision-making and help make sure you’re able to communicate your wishes to your health care provider.

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Separating Mom and Baby

Labor is over and your bundle of joy has finally arrived! But before you know it, your baby is whisked out of your arms or away to the nursery. That’s because in many hospitals, it’s standard procedure to separate mom and baby for a period of time, to complete some nursing tasks. However, research has shown that it’s best for mothers and their healthy baby to stay together after birth. Talk to your care provider and make sure they allow “rooming-in,” which will maximize your time with your little one and opportunities for breastfeeding. Don’t forget to talk about what will happen immediately after birth, too. Many things like weighing, measuring and bathing are not urgent and can be delayed, or done at your bedside or right on your tummy to ensure you and your new baby don’t miss a beat.

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What’s Next?

So, how do you get a better idea of the care your doctor or midwife will provide? Ask good questions! Take a look at some suggestions.

Talk Back

How about you? Are you hoping to avoid certain interventions in your baby’s birth? Have you experienced interventions that made your birth harder? Did you successfully avoid an intervention that helped make your birth easier and safer? Tell us your story in our comments section here.

5 Ways to Be Your Own Best Advocate for During Birth

When seeking to maximize your comfort and minimize interventions during your hospital birth, there are simple things you can do to advocate for yourself. Be sure to also share these tips with your partner and birth support team, as they will be able to help advocate on your behalf while you are busy laboring. 

1. Request your nurse. While this isn’t always a possibility, you can ask upon check in for a nurse who is comfortable supporting a mom who is laboring without pain medication (if that is your preference). Similarly, if you end up with a nurse who is not the best fit, you can ask (politely) to have a different nurse.

2. Get out of the bed. Laboring in a bed, on your back, is a very uncomfortable position to experience contractions. But upon entering the hospital, you are asked to get into bed to be monitored, insert an IV port, and other general hospital procedures. You do not, however, have to do this lying down in bed! You can let your nurse know that you would like to sit up in bed, stand, sit on a birth ball, or kneel — positions that are all compatible with most hospital admittance procedures.

3. Get monitored and then get off. Most hospitals require a standard 15 minutes per hour monitoring on an electronic fetal monitor. If you’re not familiar with this device, it is made up of two elastic bands that are wrapped around your belly — one to monitor your contractions and one to monitor your baby’s heartbeat. Take note of the time you began monitoring so you can politely remind the nurse (who may have gotten tied up with other patients) when it’s time to come off. Also note that you can be monitored in other positions than lying back in bed. Most nurses are willing to work with you to find a position that is most comfortable, as long as you speak up.

4. Protect your hospital room environment. Turn down the lights, keep the door closed, adjust the thermostat, close the curtains (or keep them open!), ask for more pillows (they’re usually in a cabinet), ask for an ice pack or heating pad (some hospitals carry disposables), turn down the volume on the monitor. There are many things you can do to make your hospital room more comfortable, private, and peaceful.

5. Ask questions about procedures and ask for time to think it over when presented with a decision. Sometimes, nurses, midwives, and doctors get so caught up in the routine of their job, they forget to take the time to explain what they are doing. If you have a question about anything related to you or your baby’s care, ask! And if you are faced with making a decision (unless it’s an emergency), it’s ok to ask for more information and for more time to think it over.
photo credit: santheo via photopin cc

60 Tips for Healthy Birth: Part 5 – Avoid Giving Birth on Your Back and Follow Your Body’s Urges to Push

In this six-part series, we are sharing 10 tips for each of the Lamaze six Healthy Birth Practices that help guide women toward a safe and healthy birth. The Lamaze Healthy Birth Practices are supported by research studies that examine the benefits and risks of maternity care practices. Learn more about each practice, including short, informative videos at Lamaze.com. To read the rest of the 60 tips, check out the other posts in this series.

10 Ways to Avoid Giving Birth on Your Back and Follow Your Body’s Urges to Push

1. Learn why avoiding giving birth on your back and following your body’s urges to push is healthy for you and your baby.

2. Discuss early on with your care provider that you would like to do what comes naturally when it comes to positions and pushing during birth. If your care provider reacts negatively, this could be a red flag that she does not support evidence-based practices.

3. Take a good childbirth class to learn the many ways in which you can push out a baby, and in particular, the many positions you can push in/on/around a hospital bed that does not involve lying flat on your back.

4. Avoid interventions that restrict your mobility so you can easily move in any way you feel comfortable, including positions for pushing, like on all fours, standing, squatting, and side lying.

5. If interventions become necessary, involve your labor support team to help you remain as mobile as possible and get into upright positions for birthing.

6. Learn the difference between directed pushing and pushing with your body’s natural urges.

7. Include details in your birth plan about your preferences to push in a position that is most comfortable to you and to follow your body’s natural urges to push (ie, please don’t count or coach for pushing). Share your birth plan with your care provider during your pregnancy, and bring a copy of your birth plan to your place of birth to share with your nurses/attendants.

8. Consider “laboring down” to shorten the amount of time spent actively pushing and to provide you with more energy to push in upright positions.

9. If you are birthing at a hospital, ask your nurses in advance of pushing about using the squat bar. Nearly all maternity beds come with a squat bar attachment, but staff may need some time to locate it and bring it to your room. The squat bar  is an excellent tool that can help support your squatting position in labor and birth. It can even be used for women who have an epidural.

10. You may find that pushing on your back and/or pushing with the encouragement or coaching of your labor support team is actually helpful — and that’s ok, too! Labor and birth is about what works best for you and your baby to have the most healthy and positive experience.

60 Tips for Healthy Birth: Part 4 – Avoid Interventions that Are Not Medically Necessary

In this six-part series, we are sharing 10 tips for each of the Lamaze six Healthy Birth Practices that help guide women toward a safe and healthy birth. The Lamaze Healthy Birth Practices are supported by research studies that examine the benefits and risks of maternity care practices. Learn more about each practice, including short, informative videos at Lamaze.com. To read the rest of the 60 tips, check out the other posts in this series.

10 Ways to Avoid Interventions that Are Not Medically Necessary

1. Learn why avoiding interventions that are not medically necessary is important for you and your baby.

2. Ask your care provider (the earlier, the better) about the kinds of interventions they use and when they use them. You can ask about their rates of interventions, but you’ll  most likely get more accurate and telling answers with more open-ended questions, like, “For what reasons would you recommend an induction?” and “Why would I need a cesarean?”

3. Take a quality childbirth education class to really get to know different interventions and how they interplay with one another. For example, you cannot be induced without having continuous external fetal monitoring and IV fluids.

4. Learn about the interventions used regularly at your chosen place of birth. Sometimes, those rates are available publicly and sometimes (more often), they are not. You can also ask during your hospital tour or at a prenatal visit with your care provider. But your best bet is to ask local doulas and childbirth educators, who will most certainly have insider knowledge.

5. Research and practice a variety of coping and comfort measures, as well as position changes, to use during your labor and birth.

6. Consider hiring a doula, who is trained on the use of interventions and can offer additional resources for you to make the best informed decision about your care. A doula will not advocate on your behalf, but can help you be a better advocate for yourself.

7. When you hit 40 weeks and there is no sign of labor, remind yourself that 40 weeks is not a deadline but a vague estimate and that a healthy pregnancy can go to 42 weeks and beyond. Also remind yourself that you will not, in fact, be pregnant forever. As uncomfortable as you may be at 40 weeks of pregnancy, the healthy choice in most cases is to let labor begin on its own.

8. If faced with the decision to induce your labor, first find out why, and second, find out your Bishop’s Score. And, learn why an induction might be necessary and when it is not.

9. Make sure your partner or birth support person (spouse, partner, friend, family member) knows about your birth preferences and understands how best to support you during birth. Your birth partner will be an invaluable asset to your birth experience.

10. Interventions can be medically necessary and life-saving. If interventions become necessary, find out how you can keep your labor as healthy as possible.

 

photo credit: Rick Bolin via photopin cc

The Straight Scoop on Inductions

The holidays are upon us. If you are due on or near a major holiday, you will be more likely to face the decision of whether or not to get induced to go into labor. But before you succumb to the pressure of planning your baby’s birth date to avoid a holiday, first consider the realities — and risks — of induction. Lamaze created a the following infographic to illustrate the problems with, pressures of, and decision points surrounding induction. For more information on induction, check out the resources on Lamaze.org.

 

 

If You Have an Epidural: How to Keep Your Body and Labor Moving


Epidural anesthesia
delivers a combination of anesthetic (numbing) and narcotic medication into the epidural space outside of your spinal cord. The medication creates a loss of feeling from your midsection on down to your feet. Depending on the dosage of an epidural, you may have complete loss of feeling and movement in your legs, or you may be able to  easily feel the pressure of your contractions and be able to move your legs (though most hospitals will not allow you to walk due to the risk of falling). You can discuss your dosage preferences with the anesthesiologist who places the epidural. Ideally, in order to feel how and when to push your baby during birth, you will have an epidural that provides relief, but not complete loss of sensation. You may need an epidural if:

  • Your labor is very long and difficult and you need to rest.
  • You have a cesarean.
  • Your blood pressure is very high.
  • You don’t have good labor support.
  • Your birth site restricts your ability to find comfort in other ways.
  • You can’t move beyond your fear of labor pain.

If you have an epidural, it is important that you keep your body moving as much as possible during labor. Staying mobile during your labor encourages your body and baby to work with gravity and movement, helping your baby to descend and progressing your labor. Usually, your nurse will be in charge of helping you rotate/flip every 30 minutes to an hour. It may help to set your own timer to ensure that you keep moving regularly. You can enlist help from your nurse, your partner, and your doula to move. But how do you move with an epidural? Renowned author, doula, childbirth educator, and birth counselor Penny Simkin, PT, created what she calls the “Rollover” technique (shown in the image below and explained in detail here at Spinning Babies) to help women stay as mobile as possible during labor with an epidural. The positions used in this technique make use of an adjustable hospital bed and props like pillows and a yoga ball to move your body and open your pelvis, both of which help progression of labor.

 

If you wish to avoid the use of an epidural, follow these helpful tips, from The Official Lamaze Guide: Giving Birth with Confidence.
  • Labor at home as long as possible.
  • Choose your caregiver and birth site carefully.
  • Discuss your desires with your caregiver.
  • Make sure you have excellent labor support.
  • Use all the non-drug comfort measures you can.
  • Be patient and remember that your body knows how to give birth.

Healthy Birth Practice 1: Let Labor Begin on Its Own

Adapted from The Official Lamaze Guide: Giving Birth with Confidence.

Letting your body go into labor spontaneously is almost always the best way to know that your baby is ready to be born and that your body is ready for labor. In the vast majority of pregnancies, labor will start only when all the players—your baby, your uterus, your hormones, and your placenta—are ready. Naturally, labor usually goes better and mother and baby usually end up healthier when all systems are go for birth. Every day of the last weeks of pregnancy is vital to your baby’s and body’s preparation for birth.

If your labor is induced (started artificially), it becomes a medical event and proceeds quite differently from spontaneous labor.  Unless you or your baby has a health problem that necessitates induction, it makes sense to wait patiently for your labor to start on its own. Even if your due date has passed and you’re longing to hold your baby, remember that nature has good reasons for the wait.

  • Download the Lamaze Healthy Birth Practice Paper, available in eight languages, to learn more about induction of labor.
  • Learn some tips for avoiding labor induction.
  • Find out how to keep labor as natural as possible if you have a medical reason to be induced.
  •  Watch a video on why to let labor begin on it’s own.

 

For additional resources on induction, check out the following links:

 

What to Know if Your Labor Stalls

Labor is unpredictable. We have no way of knowing in advance when labor will begin, how long it will last, or how it will feel. Sure, there are some universal markers and generalizations about the process of labor, but every experience is different, and the variables are numerous. First-time mom vs. mom with a subsequent baby, baby’s position during labor, home or birth center birth vs. hospital birth, pain med-free birth vs. heavy intervention birth, complications vs. low-risk mom… the list could go on. All of these factors influence the course of labor and birth.

Perhaps one of the most variable parts of a woman’s labor is length. Healthy babies and mamas can come through a labor that lasts 3 hours, 12 hours, or 48 hours (or longer). Despite this fact, many health care providers in the United States place time limits on a woman’s labor in the hospital. It is not uncommon for a doctor to recommend the use of Pitocin to speed up labor if a woman’s cervix has not changed dilation in two hours. As a standard practice, obstetricians are encouraged to govern labor by Friedman’s Curve, an analysis developed in 1955 by Dr. Emanuel Friedman that dictates how a woman’s body should progress in a normal labor. The problem with this? According to Rebecca Dekker, PhD, RN, APRN, of Evidence Based Birth, who recently investigated this practice:

“Modern researchers have come to the definitive conclusion that we can no longer apply Friedman’s curve to women of today’s world. Too many things have changed since 1955. Women are no longer sedated during labor, but epidurals are commonplace; Pitocin is used much more frequently for both labor induction and augmentation, women are older and tend to weigh more, and forceps are hardly ever used. All of these things can either slow down or speed up the rate of labor.”

A “abnormal” labor, according to Friedman’s Curve, is one in which a woman is dilating less than a centimeter an hour. Care providers who adhere to these guidelines will often prescribe Pitocin to speed up labor, or if the stall continues (with no dilation for 2 or more hours), may call “failure to progress” and recommend a cesarean. According to Dekker’s article, research published this year from a sample of 38,484 women showed that “10%, or 1 in 10, of all first-time mothers in the U.S. had a cesarean for failure to progress during the years 2002-2008 (Boyle, Reddy et al. 2013).”

So, if 1cm an hour dilation is considered too stringent and outdated, how long can you safely labor before intervention is called for? In 2012, the American Congress of Obstetricians and Gynecologists, the Society for Maternal Fetal Medicine, and the National Institute for Maternal and Child Health came together and issued new guidelines for stalled (or, “arrested”) labor. Among the guidelines, as posted in Evidence Based Birth’s article:

“Progress in the first stage should not be based solely on cervical dilation but must also take into consideration change in cervical effacement and fetal station. Similarly, progress in the second stage involves not only descent, but also rotation of the fetal head as it traverses the maternal pelvis.”

“Adequate time for normal latent and active phases of the first stage, and for the second stage, should be allowed as long as the maternal and fetal conditions permit.”

“1st stage arrest can be diagnosed ONLY if a woman has reached 6 cm and the water has broken, AND if there has been no cervical change for 4 or more hours of adequate contractions or 6 or more hours of inadequate contractions. If the mom is still less than 6 cm, then she needs additional time and interventions before an arrest of labor can be diagnosed, because she is still in early labor.”

Stall during pushing can be “diagnosed if there has been no improvement in descent OR rotation of the baby after at least 4 hours in first-time moms with an epidural, at least 3 hours in first-time moms without an epidural, at least 3 hours in experienced moms with an epidural, at least 2 hours in experienced moms without an epidural.”

Stall of an induced labor can be diagnosed if there is “failure to have regular (every 3 minutes) contractions and failure of the cervix to change after at least 24 hours of oxytocin (and if the water has been broken, if possible).”

How can you avoid unnecessary interventions due to a stalled labor? First, be sure to talk with your care provider well in advance of your birth. Find out her policies on allowing a normal labor to progress. If you are in labor and your care provider recommends Pitocin or cesarean due to stalled labor or “failure to progress,” there are three questions to ask your care provider that will help you assess your situation:

  • Is my baby OK?
  • Am I ok?
  • What’s the risk in doing nothing or waiting? 
You can also ask your care provider about using natural techniques to get labor moving again, including:
  • Walking, moving, changing positions
  • Laboring in the shower
  • Change in environment (time alone, dimmed lights, music, etc)
  • Nipple stimulation
The most important thing to know about a stalled labor is that it is usually not an emergency. As long as you and baby are healthy, you may have options outside of medical intervention.

Have you experienced a stalled labor? How did you handle it? How did your care provider react? 

 

photo credit: Jug Jones via photopin cc