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Slow labor progress

The main focal point of a slow labor is whether the contractions are strong enough. More often than not, in such cases, they will not be. If this is suspected to be the case, two courses of action are possible.

Firstly, if the membranes are still intact, the waters may be broken. This may have the effect of increasing stimulation of the uterus, resulting in stronger contractions.

The second alternative is to give the mother an intravenous infusion (drip) with the hormone oxytocin. This directly stimulates the uterus to contract more strongly.

It is important to remember that weak contractions are not the only cause of poor labor progress and it is up to the attending obstetrician to make correct analysis and institute the right corrective measure.

If labor stalls in the first stage, in spite of corrective efforts, then the doctor will have to resort to a caesarean delivery. He or she may then investigate postnatally why labor never progressed. Even then, the causes may not be identified. In fact, this is commonly the case.

Effect of pethidine or diamorphine (opiates) on contractions

There is this rather widespread notion that these pain-killers weaken uterine contractions in labor. This is actually false. Weakening of contractions is usually a figment of the imagination, brought about by the blunted perception of the pain and the sedative effect of these drugs.

Effect of epidural analgesia on contractions

An epidural does not weaken uterine contractions. It is still true, however, that the second stage may be prolonged because of blunting of the urge to push.

Remaining mobile during the first stage of labor

There is evidence that walking about during the latent and first stages of labor may somewhat reduce the distress of the pain, by giving the mind something else to concentrate upon. The shortening of labor is an unproven benefit.

Remaining mobile with an epidural

This is occasionally possible. However, this will have to be a ‘light’ epidural, so as not to deaden the legs. Another pre-requisite is the continuous presence of an assistant - be it a midwife, the partner or another responsible adult - whenever the mother is walking. This is to ensure her safety.

Eating and drinking during labor

Snacking during labor is not a good idea. Firstly, the laboring woman is unlikely to benefit from eating, because hardly any absorption is taking place from the stomach. Secondly, vomiting is rather common in labor and this can be quite distressing, especially after a meal. This takes on particular significance if a surgical procedure under a general anesthetic (such as a caesarean section) becomes necessary. Vomiting of semi-solid food can be dangerous in this state of unconsciousness as the stomach contents may be aspirated into the airway, creating a dangerous complication.

Sips of plain water or sucking on ice is OK to relieve mouth and throat dryness.

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