What does "stalled labor" mean?

[Nan'sMom]

Is it when someone is very far along in labor (like in transition) and then labor stops, signalling a possible problem? It seems to be a term used for when the care provider has decided that a woman really is in labor (as opposed to prodromal) and then it peters out or slows down, or if the care provider decides labor isn't going as quickly as he/she would like. I think maybe I am being dense, but in general, if labor slows or stops, wouldn't it mean that one wasn't really in labor or that the baby needed more time to come out?

In my own experience, I had prodromal labor for 5 weeks on and off (mostly at night), then a quick labor...I wonder if I'd had a very hands-on care provider if she/he would have decided one evening that I was in labor and then I "stalled" in the morning.

Thanks for helping me clear up yet another thing that puzzles me from birth stories!

[alegna]

What does "stalled labor" mean?

"We're tired of waiting."

-Angela

[rmzbm]

Originally Posted by alegna

"We're tired of waiting."

-Angela

: And with that the thread should be done as there ain't much left to say!

[SublimeBirthGirl]

I think that happens a lot, actually, largely because a woman who doesn't know much goes in, sure she's in labor, and when it "stalls" it's easier to induce her than send her home and she's perfectly happy to agree to that.

[Nan'sMom]

Ok, that was my initial thought too...but I always wonder if I am missing something. Thanks for the answers and the laugh!

[wombatclay]

I agree it's often "we're tired of waiting" but not always...

My first labor "stalled" and ended in a c/s. I reached 7cm and then despite back to back transition style contractions remained at 7cm (with those contractions) for 19 hours. We tried all sorts of positions, I was in and out of the birth tub and on and off the birth ball, I ate and drank at will, and my doula and care provider tried every trick they could think of. I had no meds and had already been in labor with intense contractions for more than a day.

We eventually tried a spinal to see if I would dilate further with some rest. Three hours of contractions with the spinal (I was able to walk and squat, though mostly I napped) and I was still at 7cm. When we eventually had the c/s we found that dd was OP and asynclitic with her head in a full transverse position. Her head had molded with the presentation "point" over her ear and she was wedged pretty firmly into my pelvis. There is really no way she would have been delivered vaginally...and despite massive, intense, back to back, non-stop contractions she wasn't applying pressure to my cervix and my body simply wasn't able to move past 7cm without that pressure.

So waiting longer wouldn't have made much difference other than to increase the risk of fetal distress or uterine exhaustion.

Obviously this isn't something that happens every day, and it doesn't apply to "stalls" where there are no contractions, but not all "stalled" labors are the fault of hospital policies, doctor's schedules, or medical interventions.

[Nan'sMom]

Wow, that sounds like a really tough birth, to say the least! Glad you are both ok! My first mw said that most births go fine and then there are a few where one is so glad there is the life-saving option of a c-section. Thanks for responding and sharing your experience.

[dancindoula]

"stalled" labor most often refers specifically to contractions tapering off or stopping, and yes the normalcy of this event is largely ignored and is viewed as a "failure" of the mom's body. Bunch of BS, really. Like you said, contractions can taper off because that is a normal labor pattern for some women (and gives them and babe the rest they both need), some women get a nice long "rest & be thankful" phase between transition and pushing, and often meds like epidural or narcotics can slow or stall mom's contractions (especially if the contractions were being artificially stimulated in the first place and mom wasn't really ready to labor). Really, as long as mom and baby are both healthy that resting phase, whenever it shows up, should be honored and taken advantage of. There's no reason outside of an actual medical emergency (or, as pp said, a seriously malpositioned babe) to get all flustered about it. Faster does not always equal better.

[arlecchina]

Originally Posted by alegna

"We're tired of waiting."

-Angela

:

[mom3b1?]

Originally Posted by Nan'sMom

Is it when someone is very far along in labor (like in transition) and then labor stops, signalling a possible problem? It seems to be a term used for when the care provider has decided that a woman really is in labor (as opposed to prodromal) and then it peters out or slows down, or if the care provider decides labor isn't going as quickly as he/she would like. I think maybe I am being dense, but in general, if labor slows or stops, wouldn't it mean that one wasn't really in labor or that the baby needed more time to come out?

In my own experience, I had prodromal labor for 5 weeks on and off (mostly at night), then a quick labor...I wonder if I'd had a very hands-on care provider if she/he would have decided one evening that I was in labor and then I "stalled" in the morning.

Thanks for helping me clear up yet another thing that puzzles me from birth stories!

It's a break in labor at any point.

In a perfect world it means your body is taking a little break to regroup. It's a great time to eat, think about different birthing positions and strategies that can make things move along when it's time for labor to start again, or do some exercizes to help baby reposition. Sometimes labor will stall when a mom leaves home to birth, because she's not so comfortable or doesnt' feel safe, or whatever. It's a self protective mode. That's why it's best not to go to the hospital, if you are determined to birth there, until the last minute (unless of course you need special medical support).

In a medical world it seems to mean time for a c/s, or pitocin, or some other intervention.

Kiley

[mikayla's mama]

I was in labor with my second baby, having somewhat regular contractions, I went to the hospital. I ended up dilating to a 6 while at the hospital and then the contractions stopped progressing, they weren't intensifying and I wasn't able to dilate past 6.

They offered to break my water and/or start pitocin and I said "NO WAY", just let me out of here so I can go home. They really didn't want me to leave but I did anyways, went to bed and woke up at 8:30 the next morning in hard labor. She was born 2 hours later.

I consider that "stalled labor".

I totally agree w/the PP that said your body shuts down because you are not comfortable. I had a traumatic birth with my first child. With my second, she was born within 30 minutes of arriving at the hospital.

[amitymama]

Originally Posted by alegna

"We're tired of waiting."

-Angela

[AlexisT]

*sighs*

The problem is, stalled labour CAN HAPPEN. It's because it sometimes does that doctors/nurses/midwives are able to convince women that that's what's happened, even if it hasn't.

The fact that SOME cases ("some" in this case simply meaning "not all" and not intended to quantify as any particular share of the whole) are just clock-watching doesn't mean that this is always the case. It's another example of why you need HCPs you can trust. If you think "oh, OB's just clockwatching", you might miss a real case. Some more concrete guidelines for what constitutes a genuine stalled labour would be much more useful than serving up pat generalisations.

(I'm on a pedantic soapbox today)

[SublimeBirthGirl]

What's dangerous about a stalled labor, though? What if you "miss a real case?" The uterus gets tired, it takes a break, picks up later. If the baby's okay, who cares if things stall? Mom takes a nap, things pick up again later.

[AlexisT]

In theory, yes. And as I said, often HCPs are applying some kind of arbitrary rules about how long labour should take or whatever. But my point is that patients shouldn't automatically discount the idea of stalled labour. It may happen, and sometimes there are cases like the one above where there's a genuine problem. And then the patient needs to be open to some kind of intervention.

I have heard of women, and no I am not claiming that this is at all common, whose labours stalled, who persisted, and ultimately became too exhausted to cope. These things can happen. They are rarer than some scaremongers would have you believe, but nonetheless, they are possible. I just dislike generalisations and exaggerations in either direction.

[SublimeBirthGirl]

Ok, so they become too exhausted to cope, get an epidural. And? My point is, a stalled labor when mom and baby are doing fine is no cause in itself for intervention. "Too exhausted to cope" isn't dangerous. You say "these things can happen" but I'm still not getting what "things" you're referring to, and why they're dangerous.

[prothyraia]

Originally Posted by SublimeBirthGirl

Ok, so they become too exhausted to cope, get an epidural. And? My point is, a stalled labor when mom and baby are doing fine is no cause in itself for intervention. "Too exhausted to cope" isn't dangerous. You say "these things can happen" but I'm still not getting what "things" you're referring to, and why they're dangerous.

I'm assuming the previous poster is refering to situations where the mom becomes just too flat-out exhausted to do her job, to push the baby out, that the uterine muscle can't contract over and over again forever (a couple of days, though? No problem.) If actual exhaustion sets in, though, then you're looking at instrumental or cesearean delivery.

Now, 99.9% of the time when an OB starts calling for interventions because of a "stalled labor" they're full of bs, and most of the things done to"fix" stalled labor increase the risks way more than leaving things alone would, but that doesn't mean that it can't EVER be a problem.

[AlexisT]

Originally Posted by SublimeBirthGirl

Ok, so they become too exhausted to cope, get an epidural. And? My point is, a stalled labor when mom and baby are doing fine is no cause in itself for intervention. "Too exhausted to cope" isn't dangerous. You say "these things can happen" but I'm still not getting what "things" you're referring to, and why they're dangerous.

I think you think I'm disagreeing with you more than I am. I'm NOT saying that interventions are necessary nearly as often as they're used, or that a stalled labour (stopped contractions) is inherently a cause for it. I'm only saying that a woman needs to be open to the possibility that a labour can be stalled to the point where action may be necessary, and not assume that it always means "you're taking too long". I'm not here as an advocate for over-intervention, only as a believer that some of the "MDs are always wrong" thinking that I see here is counterproductive. As I said, the scare tactics are that much more effective because the cases they describe do sometimes happen... just a lot less often than they make it seem. It wouldn't work half as well if they were always lying, now would it?

As to what things--well, like I said, mum gets exhausted. Yeah, you can get an epidural. But a labour can flat out stall where mum gets the epidural, she relaxes, her HCP is smart enough to let her keep going, and things stay stalled. No progression. There does come a point where even smart, good HCPs will say enough is enough. Or the baby's in the wrong position, and it can't progress. I'm no birth professional, I just know I have heard of women this did happen to, and they weren't giving birth in baby factories.