While there are certain universal markers for the different stages of labor, not all women experience labor in the same way or at the same pace. When a woman is in active labor and her labor slows down or stops, it is referred to as “stalled labor.” Reasons for the stall can include a slowing down of contractions, contractions without dialation, or the baby not descending, despite contractions still occurring.
A stalled labor can feel distressing and discouraging, but the good news is that it usually does not pose any danger, and it can often be resolved.
What Does it Mean to Your Caregivers?
In the hospital, many caregivers view stalled labor as something that needs to be “corrected” with interventions such as administering the drug Pitocin, artificially breaking the bag of water, or even cesarean. Labor may be considered “stalled” because caregivers compare it to “normal” labor as dictated by “Friedman’s Curve.” (In 1955, Emanuel Friedman, an American obstetrician, developed a set of data that was used to predict the speed at which a woman would dilate in labor. He found that a woman should dilate 1cm per hour once she is in active labor. Despite evidence that this practice is outdated, many care providers still use this incorrect information as a guideline.)
Know What Stalled Labor Means for You
The best way to avoid getting shuttled into the labor-Pitocin-cesarean trap where stalled labor can often lead is to know your stuff: Learn about the common causes of labor, things you can do to get labor back on track, and the best questions to ask when your doctor or midwife suggests an intervention due to suspected stalled labor.
Common Causes of Stalled Labor
Induction: Induction carries risks, one of the most common being that the induction will not “work,” ending in a cesarean rather than a vaginal birth. When you are induced, your body is artificially forced into labor, likely before you and your baby are ready. This can lead to a stalled labor, more interventions to speed up your labor, and then a possible cesarean section.
If your doctor suggests an induction, find out why, and whether or not its for a true medical reason. Ask about your Bishop’s Score, which is an assessment of how ready your cervix is for induction. The higher your Bishop’s Score, the more likely your induction will be successful (you will go into labor). If your Bishop Score is low and you and your baby are healthy, tell your care provider you would like to go into labor on your own. If your doctor or midwife presses for an induction, ask about the risk of waiting to induce until your cervix is more favorable.
Epidural: Studies have shown that an epidural can slow down the pushing phase of labor, and while data is inconclusive on its effect on active labor and transition, many women report that their contractions weakened and spaced out after receiving an epidural, often leading to the use of Pitocin to get it going again. This could be attributed to the restriction on a woman’s ability to move and change positions, or it could be due to the fact that an epidural relaxes the uterine and pelvic floor muscles.