What is Prolonged Labor?

Prolonged labor is also referred to as “failure to progress.” It occurs when labor goes on for about 18 to 24 hours after regular contractions begin. For twins, a labor that goes on for 16 hours is considered prolonged. New mothers, having their first baby, are expected to be in labor for a longer period of time, so prolonged labor may not be declared until 22 to 24 hours, whereas for the second- or third-time mothers may be considered prolonged after 16 to 18 hours. A prolonged latent phase happens during the first stage of labor. It can be exhausting and emotionally draining, but rarely leads to complications.

What Causes Prolonged Labor?

There are many potential causes of experiencing prolonged labor. During the latent phase, slow effacement of the cervix can cause labor time to increase. A baby that is very large may cause labor to take longer because it cannot move through the birth canal. The birthing canal is too small, or the woman’s pelvis is too small, delivery can take longer or fail to progress.

A breech position with the baby’s feet or bottom positioned to emerge first may also cause prolonged labor. Carrying multiples may also lead to prolonged labor, as might weak uterine contractions, or an incorrect position of the baby. Research has also linked prolonged labor or failure to progress to psychological factors, such as worry, stress, or fear. Additionally, certain pain medications can slow or weaken your contractions.

Treating Prolonged Labor

If labor is taking an unusually long time, a woman’s doctor or nurses will monitor her carefully for the timing of contractions and their strength. They will also monitor the fetal heart rate and the mother’s vital signs. If the prolonged labor continues, contractions seem too weak, or the health of the mother or baby is at risk, there are steps that can be taken to speed delivery.

If the baby is already in the birth canal, the doctor or midwife may use special tools called forceps or a vacuum device to help pull the baby out through the vagina.  If the baby has not progressed that far, the mother may need to take a medication, called Pitocin, to speed up and strengthen contractions. This medicine speeds up contractions and makes them stronger. If after your doctor feels like you are contracting enough and the labor is still stalled, you may need a C-section or if the baby is too big, or the medicine does not speed up delivery, you will also need a C-section. The Cesarean section may be the answer to several of the issues that cause prolonged labor. Nearly a third of C-sections are performed due to failure to progress. A Cesarean birth might be the best choice to avoid further complications.

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