long labor, unable to progress?

[Ygle]

This is the one hesistation I have about a homebirth (I tried searching the forums to see if this had been addressed but could only find a thread on moms not ever getting to labor in the first place). I'm just worried I won't be able to get to the pushing stage on my own. With my first I woke up around 3am Monday with strong contractions and had some water leakage that ever after just remained a slow continuous leak... the contractions remained so intense I never went back to sleep, just paced around for hours. It was a holiday (labor day!) and I was in no rush to go to the hospital so I just thought I would let things progress naturally. Tuesday afternoon I was still having strong contractions, about every 3-15 minutes, I had an OB appt. so I went in fully expecting to be told it was that time... I was about 5cm dilated but the OB didn't think I needed to be checked in yet. Didn't sleep, contractions getting much, much worse... I spent most of wednesday in a delirium in so much pain, but I was no longer thinking very clearly from lack of sleep. Thursday morning around 5am I was talking to a friend of mine when I suddenly realized my friend wasn't there! That's when I knew I really needed some help, so I called my mom over and she eventually insisted on going back to the OB's. I was 7cm dilated by then and since I was having the constant leak and constant contractions they said to go ahead to the hospital. While there my membranes were stripped, we tried warm compresses on breasts, etc... all sorts of things to try to get things going with no success. My mother, after having listened to me scream and howl for almost 12 straight hours pretty much nonstop started insisting on pain meds, so I ended up with a shot in the back (they didn't have epidurals there, it was on my charts no drugs anyways, but I was no longer responsive)... it was the first time in days I was clear headed and the pain was almost bearable. I tried to sleep, but I was so relieved I couldn't. Eventually the shot wore off and the pain from the contractions came back... at that point my OB suggested pitocin (this was after hours of, "baby's coming anytime now") and I went ahead with that. That was amazing! Labor was finally like how I had always heard it was supposed to be, my body was finally responding to the contractions and things went great from there. I was 42.5 weeks.

With my second at 37 weeks I had a nightmare root canal experience... over the course of four days I spent nine hours in the chair in excrutiating pain and the dentist still couldn't get it done or get me numb. I think the stress sent me into labor that weekend. I went into labor about 4am and had baby at 6pm that day, no intervention (although I wanted an epidural the whole time they didn't think I was really in labor until it was too late).

With my third I had a similar experience as with my first, in that I thought my water broke but after an initial flush I just had a steady leak... I had a lot I wanted to get done so I just labored at home as much as I could. I was having steady contractions for almost 24hrs when I began to just feel too exhausted and the pain seemed too intense, I kept myself very busy moving furniture and helping put in flooring and playing with the kids... if I didn't think it might go on for days I might not have been so worried. I was very disappointed that I still seemed to be going for so long. When I went to the hospital it was all the same as the first time (although for some reason they seemed more concerned about leaking fluids)... trying to get labor to start being more productive. I ended up being induced again and just like with my first labor just seemed so much better.

So do some people just not have the right hormones for labor to be productive on it's own? I worry that I will just labor endlessly never progressing to the pushing stage... I wasn't even able to enjoy my first birth at all because I was just so completely exhausted and out of it. I don't know if my husband can handle seeing me in pain for that long..


...any thoughts?

[pixiewytch]

This happened to me. My water broke and contractions remained 3-5 mins apart lasting 30-60 seconds for 24 hrs. I could handle about the first 12 hours but after that it was miserable. I did everything one is supposed to at home (stay hydrated, have a doula, support system, etc.), even tried the birthing tub for relief...all in all, I didn't progress. I finally went to the hospital after I was 7 cm and just exhausted and feeling quite hopeless. I wasn't offered any alternative to c/s since this was an attempted HBAC.

I still think it is worth trying. It doesn't happen to everyone. Birth is so unpredictable in any scenario. I think keeping realistic expectations and realizing that things don't always go according to birth plan is all you can do.

[the_lissa]

I had a long, painful, active labour with my first. I was completely exhausted and transferred to the hospital for augmentation and pain relief.

My second was a 12 hour labour home birth.

[MotheringBliss]

Have you looked into Homeopathy?

From your description, Caulophyllum may have helped considerably.

Here's a link outlining common uses http://www.whatreallyworks.co.uk/sta...rticle_ID=1204

Very gentle energetic medicine that works with the body.

[WinterBaby]

My first thought is that you have every reason to labor as well as you did with your second. My next thought is that even if you have a repeat of your more difficult labors - and there are any number of things you might try to avoid that scenario - is that if things are going poorly and not progressing you can always move on to a hospital for intervention as required. You can do this before you're thoroughly exhausted if that looks like the direction things are taking - you're not required to stick with the plan until you're no longer physically able to. However, it's hard to leave a hospital because things are going so very swimingly

[Jimibell]

Originally Posted by WinterBaby

My first thought is that you have every reason to labor as well as you did with your second. My next thought is that even if you have a repeat of your more difficult labors - and there are any number of things you might try to avoid that scenario - is that if things are going poorly and not progressing you can always move on to a hospital for intervention as required. You can do this before you're thoroughly exhausted if that looks like the direction things are taking - you're not required to stick with the plan until you're no longer physically able to. However, it's hard to leave a hospital because things are going so very swimingly

very well-put, those were the same thoughts I was having!

have you been told about the position of the babies during your 1st and 3rd labors?
with posterior babies it is not uncommon for labor to not progress because the baby's head is not pushing on the cervix.....your contractions alone have to do all the work.....
and they can change position during labor so they could have been posterior and then turned before birth....
there are things you can do to encourage a baby to move to anterior......
and if you have strong stomach muscles you may be more prone to your baby being posterior....
just a thought....

[Ygle]

Originally Posted by WinterBaby

My first thought is that you have every reason to labor as well as you did with your second.

Well, my second was not a pleasant experience being too early and I was in excrutiating dental pain, throwing up, hadn't eaten in days... I was just a mess, so I don't think it was a natural occurance... if it had been I would be much more hopeful (I also had a miscarriage after another root canal, so I think root canals -even though they say they are fine- just do not work for me being pregnant). My aunt, who had four children, also never got to the pushing stage on her own, so I just worry there isn't something inherently wrong with my hormones (possibly every one else in my family is that way as well, but they all had heavily medicated births). I know I can always go to the hospital, but if I'm not planning on it, it's just that much more stressful to me... plus, I would be paying out of pocket for midwife care, so it would be really hard to have that on top of my share of the hospital cost (I know that can happen no matter what, but I just don't really trust my own body at this point because it's never demonstrated that ability).

I just wonder if maybe I shouldn't plan on a hospital birth, then I can get the pitocin and have the strength and energy and coherance to have an otherwise 'natural' birth... if I labor endlessly going nowhere at home by the time I transfer to the hospital I would be so exhausted and disheartened I don't think I'd have the strength to deal with any headaches from staff and I'd probably end up needing more intervention... I'm having my first meeting with a midwife tomorrow, perhaps she will have some more thoughts on this for me.

Oh, my first and third were in perfect position the whole time... I even had an ultrasound with the third during labor to check fluid levels so we got a position visual... my second on the other hand wasn't, I suspect just because she wasn't ready yet, so I had terrible back labor, so I don't think positioning was the reason for my not progressing.

I appreciate all the feedback and ideas... I just don't want to make a choice and say to myself, I should've known better from my past experiences.

[pixiewytch]

That's a toughie. I will say that although insurance paid most of it we still have some unpaid medical bills for being transferred to the hospital. I can tell you that when I was in the middle of that c/s after 24 hrs of horrifying labor I told myself that I should have just scheduled the damn c/s to begin with instead of trying for an HBAC. Of course that was in the heat of the moment after a magnitude of pain, frustration, and exhaustion. Looking back, I'm glad I did try HBAC anyway. It was an incredible experience, albeit not exactly a pleasant one. It is kind of hard to explain. I'm gonna be honest and say that I would rather have an unsuccessful HBAC and transfer to the hospital than be at the hospital from the beginning. The environment is just so much different and less nurturing, not to mention all of the medical interventions that increase your risk of c/s and other problems anyway.

[umami_mommy]

while i don't think you can prevent malpositions completely... you can go a long way to prevent them by doing lots of yoga and walking and exercise while pregnant and following the suggestions on spinningbabies.com.

also i think RRL tea helps tremendously, so many women i know who have taken it throughout their pregnancies have had really short labors. (mine was 40 minutes, though i wouldn't wish my labor on anyone it was so intense, but i would take it over a long protracted labor any day)

i think visualizations goes a long way too. and i would probably recommend hypnobirthing for you.


and every baby and birth is different too.

you can do this, your body works the way it's supposed too and you can have a successful homebirth!

[Ygle]

Originally Posted by honeybeedreams

while i don't think you can prevent malpositions completely...
you can do this, your body works the way it's supposed too and you can have a successful homebirth!

Well, I'm not too worried about bad positioning since besides the one that was too early I didn't have that problem (although you never know!) and even then it wasn't a problem (I think I can handle anything as long as it doesn't go on past a day with no end in sight!) I have confidence I can make that work. But I'm still not so sure about my body... even my miscarriage had to be induced (I went six weeks after I knew the heartbeat was gone but my gestational sac kept growing so I finally opted for some help there as well).

gosh, I was so sure about this, but I'm starting to have more and more doubts.

What is RRL tea? Is that red raspberry leaf tea? I have some incredibly strong aversion to anything raspberry (no idea why, but sometimes even the smell is enough to send me into automatic vomiting convulsions... tasting it always does, which is so strange because I really think it smells and tastes good, but then I start heaving like crazy). I guess it would be worth it if that actually helps though (and I can get it down fast enough... but then if I can't keep it down, hmm)... it isn't at all dangerous or harmful? Some other berry leaf tea won't do the trick?

[Ygle]

Originally Posted by pixiewytch

I'm gonna be honest and say that I would rather have an unsuccessful HBAC and transfer to the hospital than be at the hospital from the beginning. The environment is just so much different and less nurturing, not to mention all of the medical interventions that increase your risk of c/s and other problems anyway.

I'm torn at this point... I thought I would rather do it that way as well, but I'm not sure how the rest of my family will handle it... especially my husband, I think he would be really a complete wreck if I labored for a day or so at home and nothing happened and we had to transfer. I'm just not one of those relaxed, calm, moaners and I do not handle pain well, which makes it horribly hard on him and I'm really going to need to count on his strength at the hospital, especially if I'm already worn out. But, yeah, I'd hate not to at least *try*... but then I don't want to create an even greater financial (and emotional) hardship on my family just because 'I want it'... I really appreciate your insight from your experience, pixiewytch.

[pixiewytch]

Then I guess you just have to go with your gut. If you don't feel like homebirth will be for you, it isn't the end of the world. That is okay, even if ppl here think going to the hospital is a horrible thing. However, if you do think homebirth is for you and it is simply a matter of pleasing your husband or family, then I say do whatever you can to try and make it happen. Maybe your husband would be more comfortable if you hired a doula to take the pressure off of him? I didn't have much money but I bartered for mine. It isn't your extended family's birth so don't let that influence one of the most important experiences of you life.

I just want to end by saying that we really struggled financially for our HBAC. I didn't have insurance and we had to pay out of pocket for every visit (about $500 a month) until my husband's open enrollment came around in my ninth month. There were times we almost couldn't pay rent but I did what I had to to make it happen. Now if it wasn't that important to me I wouldn't have made those sacrifices but I knew it was the right path for me. It isn't for everyone though. Follow your own heart and find out what path is for you and then do what you have to do to make it happen.

[Ygle]

Originally Posted by pixiewytch

Maybe your husband would be more comfortable if you hired a doula to take the pressure off of him? .

This is what I was thinking initially... maybe rather than hiring a midwife we should just use the money to get a doula that will look after our interests in the hospital. I have always wanted a homebirth, but I knew my husband wasn't supportive of that and I know this may perhaps be rather unconscionable and irresponsible of me but with my first I just thought I would just never go to the hospital, but by the 4th day of labor I was so out of it I was just sort of led by others. Now, I still want to have a homebirth... I'm just not sure I'm capable. I just wonder if there isn't some way around that whole experience... I know breaking my waters, nipple stimulation, walking, and having good position didn't seem to help, even though I was already in labor... do you (pixiewytch) know why things didn't progress in your situation? I don't mind the financial struggle so much for myself, but I just feel guilty taking away from the children I already have, if I have good reason to know better. I really wonder it isn't some sort of hormone issue for me considering things worked so well once I was given pitocin (seems like if it was something else than that wouldn't have been so effective... also most people I know that had pitocin described it as horrific but for me it was absolutely wonderful, but maybe that is because I was already so far along and they weren't already in active labor to begin with).

[pixiewytch]

I'm no expert and even my mw couldn't give me a really good reason for why I didn't progress. Honestly she said there was just a small piece of cervix that refused to give. She gave me EPO, she tried to stretch the membranes, and we did whatever we could to get that cervix to give but it just wouldn't. Maybe I could have waited it out but it seemed prudent to me at that point to transfer to the hospital since my water had broke so long ago, I was exhausted, and felt I might be putting my body at risk. In the end our little DD had some problems and was in NICU. She had coombs, blood incompatibility jaundice. The MW and I agreed that maybe she just needed to be born in the hospital and that was why things didn't progress. You just never know.

I think getting a doula at the hospital is a great idea and a nice happy medium if you all don't feel comfortable with homebirth.

[Jimibell]

it sounds like you are swaying toward the hospital birth....

with the right preparation and support it is possible to have an empowered birth in the hospital (although the degree does depend on the hospital of course).......

follow your heart and although your family needs to be considered, when it comes down to it, this will be your and your baby's experience, an extremely important one (as you know of course).....

also, I would say that no matter where you decide to birth, it is probably in your best interest to think as positively as possible and not to discount your body, give it a chance, this time EXPECT it to go well.......

[Ygle]

Originally Posted by Jimibell

it sounds like you are swaying toward the hospital birth.....

No way! It's looking like there is a good possibility we can get part of it paid for through insurance and after meeting with the midwife my kids are super, super excited about having a homebirth. She made me feel a little less worried about it all... I mean she said there are some more things that can be done to try to get things going (but I don't know, the cynic in me says, well, she wants me to use her! everybody's always told me what I wanted to hear in the past and then it gets to the moment and it's a totally different situation). Anyways, we're definitely decided on a homebirth... I just worry that I will be so devastated if it doesn't work out because we are all so excited about this, but I'm not even going to think about for now (or maybe I should mentally prepare myself just in case... I don't think I can though, I just can't even imagine anything else right now).

[Jimibell]

congratulations!!!
positive thinking can go a long way....
yeh for homebirth!!

[flapjack]

I have to say, in your shoes I'd try for it. One possible explanation is that your labour refused to progress because baby just couldn't get positioned right, and the reason that you were contracting so hard is because your body knew it had to to shift the awkward little one: read spinning babies for more on this one. At any point in your labours did your babies start descending though the cervix wasn't fully dilated?
I had a month of continuous contractions with my daughter, and the only thing that kept me sane was the use of a TENS machine- they're not common in the US but are over here, and can be great for a slow-to-start labour. It's really, really worth looking into. Plus homoeopathy (which didn't work for me, but reflexology did.)

[umami_mommy]

Originally Posted by flapjack

I have to say, in your shoes I'd try for it. One possible explanation is that your labour refused to progress because baby just couldn't get positioned right, and the reason that you were contracting so hard is because your body knew it had to to shift the awkward little one: read spinning babies for more on this one. At any point in your labours did your babies start descending though the cervix wasn't fully dilated?
I had a month of continuous contractions with my daughter, and the only thing that kept me sane was the use of a TENS machine- they're not common in the US but are over here, and can be great for a slow-to-start labour. It's really, really worth looking into. Plus homoeopathy (which didn't work for me, but reflexology did.)

uh, yeah, that's why i talked about malpositioning. most failure to progress is due to malpositioning. (and due to the interventive atmosphere in hospitals)

i would also suggest reading "the ecstasy of birth" here on mothering.com. talks about how birth proceeds easiest without a hospital setting (based on hormones, something you can't control).

[Ygle]

Originally Posted by honeybeedreams

uh, yeah, that's why i talked about malpositioning. most failure to progress is due to malpositioning. (and due to the interventive atmosphere in hospitals)

But I had perfect position in both cases and did most of my laboring at home (things actually went much better for me once in the hospital and getting the pitocin).

Is the TENS like one of those handheld shock you type things? I had someone try that on me at a home show once and I almost collapsed because my body convulsed so violently from it. I ended up in pain for hours from it, but I don't know if the TENS is different?

I know baby was descended... I can't remember exactly what position when though, I was fully dilated before having the urge to push though...