Problems During Labor

Fetal Distress

Fetal distress is the term applied to the condition of the fetus who is exhibiting heart rate signs of poor oxygenation. Another synonymous phrase is “fetal intolerance to labor”. Both of these terms emerged with the advent of the electronic fetal monitor (EFM). Until the early 1970’s it was quite difficult to assess the health… »

Cephalo-Pelvic Disproportion

“Cephalo-” means head, and refers to the fetus’s head. CPD refers to a fetal head which is too big to fit through the mother’s pelvic bones. Cases of true CPD will not result in vaginal birth. Borderline cases of CPD may allow the head to emerge (after “molding”) only to have the shoulders become stuck… »

Failure to Progress

This term, failure to progress, is simply that. Dilatation of the cervix and descent of the fetus fail to occur despite efforts to correct it. In the recent past, this diagnosis has taken some criticism due its use (or overuse) to justify high c-section rates. There was a time in recent history (and to this… »

Protractions and Arrests of Descent

Once the cervix is fully dilated, the baby goes through an elaborate dance, called the “mechanisms of labor”, to negotiate and descend through the mother’s pelvic bones. Usually, this process of descent takes 30 minutes to 2 hours. During this period, most women feel a tremendous urge to push the baby out, and do just… »

Protractions and Arrests of Dilatation

Protractions and arrests of dilatation happen much more commonly with first-time mothers than with experienced mothers. It’s as though the uterus is inexperienced during the first labor. As many as 30% of first-time mothers will have a protraction or arrest of the progress of labor. Often the body is just taking a rest, or has… »

Prolonged Latent Phase

If you have been contracting regularly for a period of 20 hours (14 hours if you’ve had a baby before) without a measurable change in your cervix, your midwife or doctor may make a diagnosis of “prolonged latent phase”. Under these difficult circumstances “patience” should be the guiding principle. Overly aggressive treatment (by rupturing the… »

Problems involving the Powers

The uterus is essentially a hollow muscle. When this muscle contracts it transmits its force in the direction of the vagina. Thus, anything inside the uterus is pushed down and out. Problems involving this force are some of the most common causes of problems during labor. Efficient contraction of the uterus is dependent on several… »

Problems involving the Passage

Generally, problems with the passage involve restrictions in the size of the hole through the bony part of the pelvis. Although the muscles and ligaments inside the pelvis may present some obstacle, this “soft tissue” (as opposed to bone) will almost always yield to the powers of the uterus. Very few women actually have a… »

Problems involving the Passenger

Size and position of the baby are the factors involved in problems with the passenger. Simply speaking, the passenger’s size must be somewhat smaller than the hole through the bones of the pelvis (the passage). Nature provides some mechanisms (both maternal and fetal) to provide for tight fits. The soft bones of the fetal head… »