How to Deal With Long Labors

Past Childbirth Scene (Photo credit: nep)

First and foremost, any form of labor augmentation (medical, herbal...) is cruel punishment for an exhausted mom. If mom is exhausted, activities that stimulate labor, such as walking or nipple stimulation (or sexual activity other than gentle touching), are also inappropriate. Having been in that situation three times, I have an excess of authority to declare that. Add to that adequate medical evidence to prove that speeding up a slow labor is not the best standard of care.

A long labor is defined differently in different contexts. Generally 24 hours of labor is considered very normal for a first time mom. Progress is frequently defined by how much cervical dilation occurs in a given amount of time. It's accepted that future babies “should” come faster. Given a calm, patient birth attendant and adequate support, laboring longer isn't a problem. It becomes an issue when a nurse, doctor, or midwife insists that it is an issue. If the amniotic sac is broken the risk of infection is greater (a good reason to not break it artificially), but that situation doesn't usually become life-threatening unless mom is running a fever. Medical problems occur when the mom is not allowed to rest, becomes dehydrated, and ultimately will spill protein in the urine and suffer acidosis. Labor could stop altogether at a late stage, and that can be serious.

Long labors have a lot of causes. Sometimes it is a malpositioned baby. Many times it is stress filled emotions. Sometimes it is a combination of factors. It is rare to have an actual case of obstructed labor where the baby physiologically cannot descend and a trained midwife can rule this out.

So what should be done? Ensure the mother's comfort. Hydration and nutrition are essential. Anybody will crash if they try to run a marathon without eating and drinking lots of fluids. Emotional issues may need to be let go of. Encourage mom not to fight contractions.

Now the biggest key: Rest! Mom should have private time by herself or with her partner. No harsh lighting. No noise unless mom wants soothing music.

Sleep is like a reset button for an uncoordinated labor that isn't progressing well. Hops tincture is a recommended midwifery remedy, but anything gentle that helps mom sleep without leaving her groggy later is good (a shot of wine is okay). In hospitals, an old medical standard of care was to give a small amount of morphine through the IV to ensure complete relaxation (This would have to be safer and less traumatic than hours of hard pitocin induced contractions and an epidural). When mom wakes up, her labor pattern will almost always be normal and she can go on to birth without complication.