Labor length with properly positioned baby vs. malpositioned baby?

[allisonrose]

If you have had labors with a malpositioned baby and a labor where baby was lined up well, I'd be interested in hearing the lengths of each.

I'm asking because my recent birth involved a posterior baby for much of the labor (we believe). My first labor was heavily augmented with pit because I was birthing in a hospital, was GBS+ and my membranes ruptured before contractions started. I was "allowed" to go 24 hours from rupture of membranes to birth which is relatively long for the circumstances. My second labor was a planned homebirth. I had about 48 hours of early labor (24 hours were very sporadic, 24 hours were contractions roughly every 8-15 minutes). Then somewhere in the neighborhood of 36 hours of active labor. I transferred 4 hours before my son was born and was augmented with pit in the hospital. Happily we managed a vaginal delivery.

If we decide to have another baby, I have no clue what to expect regarding labor length. I'm a bit afraid of having another labor like my second!

[LiLStar]

first, planned home birth: early labor began wed night a little before midnight. it was just enough to keep me awake all night long but not quite active labor. active labor kicked in on thursday morning. i was checked thurs evening around 5:30ish and was 8-9cm..ffwd 24hours later, after purple pushing for the better half of the afternoon in half a dozen positions, we transfer to the hospital. several hours after that (a little after midnight) I had a c-section. she was posterior and asynclitic and not goin anywhere. So that was about 49 hours, including early labor

2nd, planned (and successful!) hbac: early labor starts around 1pm, he was lined up in perfect OA (what a little angel) and was born at 3:59am, so 15 hours including early labor, or about 10 hours if you only count active. It was a nice, gentle, perfectly paced labor!

[Peony]

My first two were positioned fine, my labors with them were 19 and 8 hours. DS was was posterior baby and a 4 hour labor. I have no doubt that it would be been shorter had he been positioned better, labor started off really quick, then slowed down, and then I went from thinking sometime today this baby to come to holding him in 15 minutes. 

[cinderella08]

My 1st was positioned just fine.  LOA - just perfect.  I labored over 26 hours and resulted in a cesarean. 

My 2nd was severely  malpositioned.  He was posterior and asynclitic.  I labored 8 hours, pushed an hour, and delivered him vaginally despire him being posterior and asynclitic.  I was determined that time.

[AutumnAir]

DD1 was posterior and acynclitic. Laboured for 21 hours of active labour (with another 10-12 hours of early labour before that) before transferring to hospital and having a forceps delivery.  Dreadful.

DD2 was (I think) lined up well, though she had her hand up by her ear. Labour was about 45 minutes long total - that I noticed anyway; I think I may have been labouring through the night without really noticing, since I was waiting for the pain to get like it had with DD1 and it never even got close!

I worked really hard on OFP with both pregnancies so I don't know why one was so badly positioned and the other seemed better.

[~Amy~]

My first was very poorly positioned and ended in a c-section 14 hours after my water broke naturally (~12 hours of active labor).  My second was pit/AROM-induced and was a pretty easy vaginal delivery ~3 hours after my membranes were ruptured.  Second was positioned absolutely perfectly.

[womenswisdom]

My observations as a doula are that mamas with poorly positioned babies tend to have longer, more difficult labors. Contractions every 3 minutes from early on in the dilation process that exhaust the mamas and a more-than-typical amount of pain are common. I can usually tell if there is a posterior or otherwise malpositioned baby if mama's contraction pattern looks like transition (timing, length) but she appears normal in between. Dilation is typically 4cm or less at that point and the pattern doesn't ease up. Many times these mamas will get an epidural and the baby will end up rotating at some point (sometimes as late as pushing). I've had several mamas get the epidural and within 1-2 hours they are complete and pushing their baby out whereas prior to the epidural, they were making no progress for an good period of time. I think that exhaustion and the more-painful-than-typical contractions can cause some mamas to involuntarily tense up and they end up unable to relax and allow baby's rotation and descent and when they get the epi, they are able to relax those muscles. Sometimes (fortunately not that often with clients I've had), the epidural does not help mama to relax and allow baby to rotate and dilation stops for an extended period of time. If there are other factors at play, such as an impatient care provider or other complications during labor like a baby who is not tolerating labor well, it ends up with cesarean.

[JudiAU]

Both of my babes where posterior and both had water break about 24 hours before delivery. I dilated pretty easily with my first but there was no descent at all weird. I got an epidural when I was 8' di,a ted Fu,,y within the hour, my midwife "let" me wait five hours, and i delivered vaginally. Pushing was pretty quick. I avoided a csection simp,y because I had dropped my ob early on. Luckily I got the most liberal of the hospital midwives, the others were kind of surprised.

My second was 2 hour labor and I delivered unplanned unassisted. D got home about 20 minutes before birth but was in the other room calling the paramedics. Maybe three pushed when I realized I had a head. I had NO idea before that and I was SO glad it was going to be over. I'd seen both a chiro and acupuncturist and I think those both helped a lot,

I am baffled by the labor descriptions of others because when I go I to labor it it pretty much a nonstop contraction. No walking/ talking whatever. Very very intense. I really wanted and believe I. Natural birth and so glad I've experienced it but I don't know if I could do it in a hospital. I need to be away from the drugs.

[minkajane]

I didn't really labor with DS but with DD I was awakened at 9am by my water breaking, by 11:30 I was starting to feel pushy, and she was born at 3:22 by emergency C/S because she was footling breech. So things went FAST even though she was obviously not in the best position. I wonder how fast I would have gone if she'd been head-down!

[sharita]

1st baby, lined up perfectly.  Hospital induction.  8 hours.

2nd hospital induction, 3 hours from arrival. Lined up perfectly

3rd baby, anterior placenta for sure and posterior baby.  She turned on her own right before labor.  4 hours. (maybe more, I was woke up by labor).

4th was posterior but turned before transition.  Labor wasn't as hard as last time.  My first homebirth.  6 hours.  Maybe would have been shorter like last one if hadnt needed to rotate during labor.  Only mild back labor.

5th was another diagnosed anterior placenta and he was actually born posterior.  Water broke 36 hours before first contraction.  After first contraction though, I only labored for 2 hours.  No back labor.  WAterbirth.  One of my easiest (maybe just because it was the shortest).

This time baby was breech, but she just turned.  She is still posterior (yet another anterior placenta and my posture and lounging positions probably dont help encourage her to better position. 

Hoping for another quick one. 

I have read that there is a link between malpositioning and longer harder labors but I am proof that isnt always the case.  I think doing all you can to try and improve baby's position before birth though especially if you have a history of longer harder labors would help though. 

[miriam]

First:  ROP baby three days early, 27 hours labor. 6# 9oz. Back labor.

Second:  LOP, two weeks early, deflexed head, ascynclitism baby 9 hours labor. 6# 1oz.  Horrendous bad labor and pain. I thought I would die.

Third ROA, one day late, four hours.

Fourth ROP, three days early, four hours.

Fifth, adopted in court.  

[jcregan]

My fist was 6 hours, 4 hours active labor, 1t minutes of pushing.  She seemed very well positioned.  This was even an induction (water broke, no labor after about 14 hours).  When from 1cm dilation to baby in 6 hours (pit induction).

My second I suspect was not positioned well.  Labor was 13 hours, 30 minutes pushing.  Way more intense and would describe it as more painful.  I first labor I tend to use the term "intense" instead of painful.  I am not actually sure if he was mispositioned - I forgot to ask the midwives specifically.  He had bruising on his face.  He was 1.5 pounds bigger (same length) then my first though so it is also possible that is the reason.
 

Originally Posted by womenswisdom 

My observations as a doula are that mamas with poorly positioned babies tend to have longer, more difficult labors. Contractions every 3 minutes from early on in the dilation process that exhaust the mamas and a more-than-typical amount of pain are common. I can usually tell if there is a posterior or otherwise malpositioned baby if mama's contraction pattern looks like transition (timing, length) but she appears normal in between. Dilation is typically 4cm or less at that point and the pattern doesn't ease up. Many times these mamas will get an epidural and the baby will end up rotating at some point (sometimes as late as pushing). I've had several mamas get the epidural and within 1-2 hours they are complete and pushing their baby out whereas prior to the epidural, they were making no progress for an good period of time. I think that exhaustion and the more-painful-than-typical contractions can cause some mamas to involuntarily tense up and they end up unable to relax and allow baby's rotation and descent and when they get the epi, they are able to relax those muscles. Sometimes (fortunately not that often with clients I've had), the epidural does not help mama to relax and allow baby to rotate and dilation stops for an extended period of time. If there are other factors at play, such as an impatient care provider or other complications during labor like a baby who is not tolerating labor well, it ends up with cesarean.

Wow, seems like to you were there for my 2nd labor - lol.    My water broke and contractions started about 3 hours later.  They started as just mild cramps but were already 3-5 minutes apart and within 2 hours were 2-3 minutes apart and almost never longer apart the whole time.  I had pain in the lower part of my abdomen/pelvis that I did not have with my first.  It was a sharper stabbing type of pain and more localized.  With my first I just remember a general intensity across the whole uterus.   The feeling from my first labor was much easier to cope with.   This 2nd I spent much of the time thinking I to be close to transition because the intensity and pain of the contraction was what I remembered from transition with my first (and i was expecting it to be faster).  The midwife would check me and I was only 4 cm etc., I was frustrated and kind of confused by that the whole time.  Kind of like "why to I feel this way when I am only 4cm?!".  I progressed at a steady pace and compared to some labors it was not that long, just not what I was expecting.  I do remember laughing at some point in between contractions and the midwife seeming surprised by that and commenting about it.    I managed without an epidural but considered it often.  I have horrible veins and the last IV took 3 or 4 tries and special IV person to get it in.  This is pretty much what stopped me from getting the epidural - I did NOT want the bother of the IV.