©Pregnancy bliss 2008
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Prolonged labor
The most common cause of prolonged labor is inefficient contractions. If the contractions are weak, irregular or uncoordinated, they may be unable to facilitate dilatation of the cervix and push the baby further down the birth canal.
This problem is most often overcome by using an oxytocin infusion. Oxytocin is actually the natural chemical that is produced in the brain to stimulate contractions. Labor augmentation is discussed in greater detail here:
Other causes of prolonged labor
For an above average sized baby and if the baby is large relative to the size of the mother's pelvis, there is potential disproportion. If the disproportion is only slight, the strength of the contractions may overcome it. Sometimes, however, the disproportion is considerable and labor fails to progress beyond a certain point.
It is usually not easy to accurately predict that vaginal delivery is not achievable during labor. The realization that there was disproportion is usually retrospective after a prolonged labor culminating in a cesarean section.
An abnormal position of the baby's head in the mother’s pelvis can cause slow progress of labor.
Normally, the head will be facing downwards with the neck of the baby bent forward
and the chin resting on the chest. If the head descends into the pelvis with the
neck extended and facing upwards (‘star-
The cervix as a cause of prolonged labor (cervical dystocia)
Yes. Occasionally, in spite of strong, regular contractions, the cervix does not continue to dilate beyond a certain point. In most cases, the cause of this is obscure. A situation where the cervix is unyielding in labor despite strong regular contractions is called cervical dystocia.
Occasionally, the cervical resistance may be due to scarring resulting from previous surgery or injury.
When labor has been induced, it is important to ensure adequate cervical preparation
before stimulating contractions. If contractions are stimulated before the cervix
is ready (i.e. while it is still long, firm and closed), there is a risk that it
may not dilate, a situation that could culminate in an otherwise unnecessary cesarean
section. This is why the application of prostaglandin preparations is sometimes necessary
before stimulating contractions. These preparations come in a form of tablets (suppositories),
gel or steady-
