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Labor not progressing??

Posted by on Jun. 26, 2010 at 1:02 PM
  • 21 Replies

What does that mean?

I've seen many ladies give that reason for needing a c-section and not being able to do a VBAC, but I am SOOOO unclear on what that means!

Wouldnt you not "progressing" mean you either arent in labor, or that its just a long labor? How long are you in "labor" before they say you arent progressing???

I have no clue...LMAO!

Pregnancy%20ticker

by on Jun. 26, 2010 at 1:02 PM
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Replies (1-10):
Mia055
by on Jun. 26, 2010 at 1:07 PM

 With my first son i went into labor at 1245 am...at the hospital and admitted at 340 am and from that time till 10am i was stuck at 3 cm...got my water broke and went to 4 cm and it stopped so they had to induce me to keep it going (NEVER want PITOCIN ever again-sorry i know i say that all the time but it really sucked for me) But anywho, my never did end up to being a c-section, labor altogether was 19 hours exactly =)

doulala
by on Jun. 26, 2010 at 1:13 PM

Well, "FTP" is vague and usually more like a "failure to wait."   Or to be patient, or try other routes.    If a mom is in a hospital birthing she is much more likely to have this because she is "on the clock."


:-(












 

Many C-Sections Can Be Avoided By Waiting Out Stalled Labor, UCSF Study Shows

Pregnant women whose labor stalls while in the active phase of childbirth can reduce health risks to themselves and their infants by waiting out the delivery process for an extra two hours, according to a new study by researchers at the University of California, San Francisco.

By doing so, obstetricians could eliminate more than 130,000 cesarean deliveries - the more dangerous and expensive surgical approach - per year in the United States, the researchers conclude.

The study examined the health outcomes of 1,014 pregnancies that involved active-phase arrest - two or more hours without cervical dilation during active labor - and found that one-third of the women achieved a normal delivery without harm to themselves or their child, with the rest proceeding with a cesarean delivery.

The findings appear in the November, 2008 issue of Obstetrics and Gynecology, the official journal of the American College of Obstetricians and Gynecologists (ACOG).

While ACOG already recommends waiting at least two hours with adequate contractions in the setting of no progress in active labor, it is routine practice in many clinical settings to proceed with a cesarean for "lack of progress" before those ACOG criteria have been met, according to Aaron Caughey, MD, PhD, an associate professor in the UCSF Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Maternal-Fetal Medicine, and senior author on the paper.

"One third of all first-time cesareans are performed due to active-phase arrest during labor, which contributes to approximately 400,000 surgical births per year," said Caughey, who is affiliated with the UCSF National Center of Excellence in Women's Health. "In our study, we found that just by being patient, one third of those women could have avoided the more dangerous and costly surgical approach."

The cesarean delivery rate reached an all-time high in 2006 of 31.1 percent of all deliveries, according to the UCSF study. Arrest in the active phase of labor has been previously shown to raise the risk of cesarean delivery between four- and six-fold.

"Cesarean delivery is associated with significantly increased risk of maternal hemorrhage, requiring a blood transfusion, and postpartum infection," Caughey said. "After a cesarean, women also have a higher risk in future pregnancies of experiencing abnormal placental location, surgical complications, and uterine rupture."

The ten-year study identified all women who experienced what is known as active-phase arrest during their delivery at UCSF from 1991 to 2001. The study only included women with live, singleton deliveries who were delivered full-term.

The researchers examined maternal outcomes such as maternal infection, endomyometritis, postpartum hemorrhage and the need for blood transfusions. It also examined the infant's Apgar score, rates of infection and frequency of admission to the neonatal intensive care unit, among other health indicators.

The study found an increased risk of maternal health complications in the group that underwent cesarean deliveries, including postpartum hemorrhage, severe postpartum hemorrhage and infections such as chorioamnionitis and endomyometritis, but found no significant difference in the health outcomes of the infants.

It concluded that efforts to continue with a normal delivery can reduce the maternal risks associated with cesarean delivery, without a significant difference in the health risk to the infant.

"Given the extensive data on the risk of cesarean deliveries, both during the procedure and for later births, prevention of the first cesarean delivery should be given high priority," Caughey said.

----------------------------
Article adapted by Medical News Today from original press release.
----------------------------

Co-authors on the paper were Dana E.M. Henry, MD; Yvonne W. Cheng, MD, MPH; Brian L. Shaffer, MD; Anjali J. Kaimal, MD; and Katherine Bianco, MD, all from the UCSF Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Maternal-Fetal Medicine.

Funding for these studies came from research funds from the National Institutes of Health for Henry and Kaimal. Caughey is supported by a National Institute of Child Health and Human Development grant and the Robert Wood Johnson Foundation. The authors have no potential conflicts of interest to disclose.

UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. For further information, please visit http://www.ucsf.edu/.

 

http://www.medicalnewstoday.com/articles/127827.php







 

"The better the obstetrician, the more like a midwife he or she becomes."



Nancy Wainer Cohen

Sweet_Britt
by on Jun. 26, 2010 at 1:42 PM

Oh, so its pretty much exactly what I thought...just that its lack of patience due to a long labor, or not actually being in active labor, but in prelabor...

How do preggo women protect themselves from that happening to them? Where the docs are pushing and pushing for a c-section, shes in pain and weak from contractions, and they make her feel like if they dont get this baby OUT, there will be some crazy risks/side effects?

Quoting doulala:

Well, "FTP" is vague and usually more like a "failure to wait."   Or to be patient, or try other routes.    If a mom is in a hospital birthing she is much more likely to have this because she is "on the clock."


:-(



Pregnancy%20ticker

mamakristena210
by Silver Member on Jun. 26, 2010 at 1:47 PM

i just read a story on here like a week ago that a girl stopped progressin round 6or 7cm i think the decided to go do c section. and when they did she found ot she couldnt even deliver a 3 lbs baby cuz like her pelvic bone or somethig wouldnt let her. so she has to have c section every baby. so altho i agree sometimes they do it for their own selfish reason. docs do have reasons for what they do.

doulala
by on Jun. 26, 2010 at 2:06 PM

It has so much to do with who you hire to attend your delivery, honestly.
But also moms education and confidence, too.

If you hire a surgeon (OB), you are much more likely to have some reason that "needs" intervention/a cesarean.

That is what doctors are trained to do:  deal with complications.   (And find them...    often even invent them.)

Women who are encouraged prenatally & in labor, to follow their instincts will be more likely to have a successful-normal outcome.    This kind of care & encouragement happens more often with Normal Birth Specialists (midwives) than surgeons/high-risk specialists.


If it's too late, you are in labor and hearing that you're "on the clock," get strong/advocated and get the FACTS.
Find out if this pressure is due to a convenience reason or a true complication...
From the statistics, we know that MOST of this pushing/pressure comes from more of a convenience standpoint than a TRUE complication issue.

So get a good care provider.
Get educated.
Get an advocate.
Stay strong in labor.
And of course, stay upright-wriggling-moving-moaning-instinctive through the labor!

;-D

Quoting Sweet_Britt:

How do preggo women protect themselves from that happening to them? Where the docs are pushing and pushing for a c-section, shes in pain and weak from contractions, and they make her feel like if they dont get this baby OUT, there will be some crazy risks/side effects?

Quoting doulala:

If you don't know your options, you don't have any.           ~Korte & Scaer

Mothers need to know that their care and their choices won't be compromised by birth politics.                                                                                            ~Jennifer Rosenberg

Midwives
see birth as a miracle and only mess with it if there's a problem;
doctors see birth as a problem and if they don't mess with it, it's a
miracle!     
~Barbara Harper

doulala
by on Jun. 26, 2010 at 2:09 PM


Quoting mamakristena210:

i just read a story on here like a week ago that a girl stopped progressin round 6or 7cm i think the decided to go do c section. and when they did she found ot she couldnt even deliver a 3 lbs baby cuz like her pelvic bone or somethig wouldnt let her. so she has to have c section every baby. so altho i agree sometimes they do it for their own selfish reason. docs do have reasons for what they do.

This is a common "reason" so it doesn't sound unusual.   But I wasn't there, lol, I don't know that story, but I do know that there are many stories like this where the mom goes on to birth BIGGER babies later on (with different doctors, of course!).


As an American, I know that maternity care is terrible in my country, don't know where you are, and that moms must defend themselves.     We can blindly trust in our doctors, maybe we are okay with this.   But unfortunately, it's not usually the safest route.     We need to be informed, educated, strong!

;-)








Just as a woman’s heart knows,

How and when to pump,

Her lungs to inhale,

And her hand to pull back from fire,

So she knows when and how to give birth.


- Virginia Di


ICAN

ElijahsMom211
by Platinum Member on Jun. 26, 2010 at 2:14 PM

Wow!! That's a good question, I never even thought of it like that.. :o) BUT I have NO idea for an answer so here's a bump!

How are you doing btw? How's baby?

truealaskanmom
by on Jun. 26, 2010 at 4:48 PM

The only time failure to progress should turn c-section is when the long labor causes true distress in the mom or baby, other than that the stalls are just ways to give mom a break to regain some energy get some rest and food etc.  It is hard to fight when you tired I know that was part of my issue with my first, I was exhausted and gave in to things I shouldn't have . I am a huge advocate of making sure that once you hit the last month and a half you get as much rest as you can, and you eat eat eat and drink drink drink and take your vitamins.  These things will help stay the exhaustion and make it easier to say no.  ALso when you stall it is a sign to get up move around find new positions etc just like pain is an indicator of the same thing.  If you are active in labor it will help it go faster than if you get strapped to a bed and don't take action KWIM.  If you have an OB it is harder to fight they use it all the time, but if you know it is crap call them on it. 

linnymichlle
by on Jun. 26, 2010 at 4:52 PM

well I wanted a vbac but my doctor is only giving me a week past my due date  so Iam praying in that time frame I go into labor

truealaskanmom
by on Jun. 26, 2010 at 4:57 PM


Quoting linnymichlle:

well I wanted a vbac but my doctor is only giving me a week past my due date  so Iam praying in that time frame I go into labor

You know it isn't up to your doctor it is up to you, you don't have to have a c-section if you don't want one.  Don't sign anything.  There is a mom who had her vbac at 42 weeks 1 day she stopped answering the phone and avoided her doctor to get there but she did.

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