What Is Prolonged Labor?
Prolonged labor, also called “failure to progress” or “dystocia,” refers to labor that proceeds at a slower-than-average rate.
Labor is the process by which the baby and placenta leave the uterus. Labor is defined by the onset of regular contractions of the uterus and cervical change (dilatation of the mother’s cervix). There are three stages of labor:
- First stage: This is from the beginning of contractions to the time that the mother’s cervix is completely dilated and the mother is ready to begin pushing. The first stage is subdivided into latent and active phases. The active phase begins when the rate of cervical dilatation speeds up, which generally happens at about four centimeters.
- Second stage: This stage begins when the mother’s cervix is fully dilated and ends with the delivery of the baby.
- Third stage: This is the time from the delivery of the baby to the delivery of the placenta.
Prolonged labor may occur due to many factors such as:
- The size of the baby or the baby’s head relative to the mother’s pelvis or birth canal (cephalopelvic disproportion)
- Abnormal position of the baby in the birth canal (fetal malposition)
- Inadequate or ineffective contractions
- Epidural anesthesia
Monitoring of Prolonged Labor
When labor is prolonged, the baby may be stressed and unable to tolerate labor. Medical professionals must carefully monitor the baby’s heart rate on the electronic fetal heart monitor to watch for signs that the baby isn’t getting enough oxygen or isn’t tolerating labor. The doctors and nurses may also use an intrauterine pressure catheter (IUPC). An IUPC is a tiny monitor that is inserted into the mother’s uterus to measure the strength, length, and frequency of the uterine contractions. If the contractions are not adequate, the doctor may choose to give the drug Pitocin to increase the strength, frequency, and duration of the contractions to move the labor along.
Risks Associated with Prolonged Labor
There are risks to the baby with prolonged labor:
- Low or inadequate oxygen, resulting in hypoxia, asphyxia, acidosis, and hypoxic-ischemic encephalopathy (HIE)
- Fetal distress
- Intracranial hemorrhaging
Treatment of Prolonged Labor
Depending on the baby’s location or "station" in the birth canal, the doctor may perform an operative vaginal delivery, which is a vaginal delivery using a medical device, either a vacuum extractor or forceps, to pull the baby down the birth canal. Both the vacuum extractor and the forceps can be potentially dangerous if not used correctly. There must be a clear and proper medical indication to use a vacuum extractor or forceps, and these devices must only be used by qualified and experienced doctors.
If there is fetal distress, if there are signs that the baby isn’t getting enough oxygen, or if the labor is stopped such that a safe, vaginal delivery is not likely, then the baby may need to be delivered by Cesarean section.
Negligent Failure to Perform a Cesarean Section (C-Section)
Common allegations in medical negligence lawsuits involving prolonged labor and birth injuries include:
- Failure to properly monitor the baby’s heart rate to detect and treat fetal distress
- Failure to timely perform a C-section
- Improper use of forceps or vacuum
Hospitals and hospital systems should provide training to labor and delivery nurses and ensure that they are competent to monitor the mother and the baby, to recognize protracted labor, to recognize abnormal fetal heart rate patterns and fetal distress, and to timely communicate the correct information to the doctor so that a Cesarean section delivery can be done to protect the baby. If not, babies are at risk of serious hypoxic-ischemic injury or death.
Prolonged Labor Birth Injury Lawyer
Prolonged labor and delay in performing a C-section can result in hypoxic-ischemic encephalopathy, seizures, and cerebral palsy.
The effects of a serious injury caused by prolonged labor can last for a lifetime. The costs of medical care, rehabilitation, therapy, assistive devices, etc., can be very significant. Even though parents are willing to sacrifice everything to better their child’s life, they should not have to pay for the harms and losses caused by preventable medical mistakes.
If your labor was prolonged and your child has suffered an injury, Please call (866) 393-2611 to speak with a dedicated birth injury lawyer. The Texas birth injury attorneys at Brown Trial Firm will provide a free consultation and will investigate your delivery to determine if your child’s injury could have been prevented.