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Originally Posted by CI Mama  I labored for 33 hours with my DD, and that felt like a long labor to me. But I've read stories here from women who've labored for far longer, which has made me curious about what is considered a "long" labor.
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I'd consider 33 hours of active labor long. But a labor with a long latent phase, wherein you labor for 4 hours a night for 4 nights, with breaks inbetween, then have 17 hours of labor that progresses and leads to birth, is longer from first contraction to baby born, equal in cumulative hours of contractions, but easier on the mama because she gets breaks to rest and eat. I would unscientifically define long as any length of time over 24 hours that pushes the mother waaaaay past the point at which she thought she could endure, but somehow she does.
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| Is there a rule for determining that a labor has lasted long enough or is progressing slow enough to be considered "long"? |
24 hours is not unreasonable, but my rule would be that when the mama is totally schwacked and tired beyond the point of endurance and
no progress, however incremental, has been made for a number of hours (like 3 or 4), or if baby is starting to sound like he's not tolerating labor well, then it's been long enough, and some sort of intervention is appropriate. But if everyone's energy is good and baby sounds like he's still happy, then there's no reason to put a time limit on it. Simply being slow is not truly a problem.
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| Is there a way to predict that a long labor is likely (either prior to labor starting and/or during the early hours of labor) and to prepare for its length? Are there things that can be done in late pregnancy to create better endurance in the event of a long labor? |
If you have a posterior baby, I think you can reasonably predict a longer, more energy-intensive labor for mama. Better to head that one off at the pass - get regular chiro. treatment, use good posture, do yoga and lots of cat-cow, don't use recliners, sit on the floor, use good posture (yes, I said it twice). Stay active all the way through the pregnancy, don't eat a crummy diet. Better to prepare for a short birth than to prepare to endure a long one.
That said, sometimes these things are out of our control. To prepare for a long birth, make sure you have a good place to labor - good means you have access to food, a resting area, a walking area, a sitting on a ball area, water (tub or shower), and a supportive team. Have distractions ready - tasks to do in early labor, music, a movie. Have comfort measures in place - rice sock, birth ball, massage tools, etc. Have coping skills - self-hypnosis, acupressure points, massage, dancing with partner - that you can use.
Stay active all the way through the pregnancy, don't eat a crummy diet.
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| Is there a rule for determining when interventions have more benefits than risks in terms of helping a slow/long labor progress? |
Labor progress can be slow for physical, physiological, or psychological/emotional reasons, and different interventions might help one but not another. If you can be proactive with the low-tech interventions early on, maybe the higher-tech ones will never be needed. Try to reposition the posterior baby sooner rather than hoping he turns on his own. Use nipple stimulation for increasing contraction strength before the mom is totally exhausted.
I think it's a delicate thing to know what that tipping point is for hospital-based interventions, but I would say that 1) a mother knows when she is
done and needs pain relief to cope so that pain doesn't veer into suffering and so she has the energy to go the distance in a long labor, and 2) if the baby's heart rate is starting to look bad, then interventions start looking like better options than doing nothing, especially if they are accompanied by maternal fever and exhaustion.
For physical/fit problems - If baby is in a poor position, can he be rotated or helped to move lower in the pelvis to apply better pressure to the cervix? Can counterpressure or hip squeezes open the pelvis a little extra? Can a knee-chest position allow baby to back out of the pelvic inlet a bit to reposition himself? Can a rebozo help jiggle him into a better position? Sometimes, there is true cephalo-pelvic disproportion, but it's fairly rare.
For physiological things - can nipple stimulation help get a better contraction pattern going? Can walking pick things up? If mama is tired, can she rest, eat, get some relief from pain? I think that it can be very appropriate to use pit. and/or request an epidural if mama is so exhausted that contractions are petering out, but baby needs to be born because of ruptured membranes for going on 24 hours. And back labor can be
so painful and
so exhausting for the mother that I think an epidural can be a godsend in some labors, the only thing that will allow her to rest enough to finish dilating.
I also think that sometimes the labor is slowed by mama's brain, and the low-tech end is to talk with her about what might be holding things up. Is there a way to help the mother feel safe or set aside her worries? Maybe she doesn't like her nurse, and just getting rid of that person will help. But if she has something like sexual abuse trauma and thinking about the birth is freaking her out, or if she has anxiety that she cannot get rid of, that can really keep the cervix closed down and hinder progress. I have seen an epidural help muscles relax when the mama is too scared or anxious and just. won't. let. go.
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| Are c-sections more likely with long labors? |
Only because the longer you labor the more time there is for baby to get stressed or for mom to get exhausted or for somebody to develop an infection, and if they are really long and unproductive, sometimes it's because there is some issue of fit that is just not resolving. But you CAN have a very long labor that results in a vaginal birth and a healthy mother and baby. It takes a lot of patience, lots of support for the mother, nourishment, encouragement, and determination.
Everyone seems to count the start of their labor differently. If you start at the first twinge it will be a much bigger number (by that thinking I was in labor for 2 weeks) and other start at hard OMG contractions or somewhere in between. I think anything more than 24-30 hours of active labor is starting to get long.
