Every woman, whether a first-time parent or a longtime one, has a unique childbirth experience. The baby may come fast or take its own time; how quickly your baby comes out depends on several things. Labour is a set of repeated and intense muscle contractions that help move the baby from the womb to the birth canal. The contractions enable the vaginal opening to widen and let the fetus come out of the body. First-time mothers are in labour for up to 18 hours, and the time is reduced by half if they have had a baby before. Continue reading to learn what prolonged and precipitous labour is and its risks, complications and more.
Prolonged labour, also called failure to progress, may last many hours without proceeding to the next stage. It is typically seen in the primary or secondary stage of labour. Labour is referred to as failure to progress when it lasts for more than 25 hours for a first-time mom and more than 20 hours for women who have had a baby previously. Typically, labour lasts between 12 to 18 hours for first births and 8 to 10 hours for later births.
● The cervix dilates but stops before it reaches 10 cm (needed for a vaginal delivery).
● The cervix is fully dilated, but the baby does not move to the birth canal.
Prolonged labour is not a common occurrence and affects only 8% of pregnant women. However, it leads to a third of all C-section births.
The first phase of labour is when regular contractions start; the cervix thins and dilates. The second stage is when the cervix is completely dilated (10 cm) until the baby is delivered. Cervix thinning is called effacement, and slow effacement is due to ineffective uterine contractions. Certain medications may weaken the contractions, increase the labour time, and slow down the birthing process.
The second phase of labour is said to be prolonged if it lasts for three or more hours for a first-time mom or two or more hours if she has had a baby earlier. It can happen because of:
● Small birth canal
● Large baby
● Small pelvis, due to which the baby cannot move down
● Inefficient uterine contractions
Studies associate prolonged labour with stress, fear and anxiety.
The main symptom of a prolonged labour is spending more time in every phase of labour with little or no progress.
There are no significant complications if there is slow labour in the first phase, although it is physically and mentally draining. However, prolonged labour in the second stage is serious as it may increase the chances of:
● Postpartum haemorrhage
● Infection
● Uterine rupture in rare cases
● Incontinence
● Prolapse of the pelvic organs
● C-section, forceps or vacuum delivery
● Infection (passed from mother)
● Heart rate drop or fetal distress
● Lack of oxygen, perinatal asphyxia
● Shoulder dystocia
The cervix dilation and effacement are checked for failure to progress. You are in prolonged labour if the baby is not born even after 20 or more hours of contractions. If it happens in the first phase, nipple massage, medications, and amniotomy (breaking of water) may be recommended. During the second phase, you may be asked to change positions, walk, rest or take medications.
Some risks of prolonged labour can be reduced, such as maintaining a healthy weight in pregnancy, as high BMI is a risk factor. However, some factors like age, carrying multiples, etc., cannot be changed. Speak to your healthcare provider to discuss how to manage a prolonged labour preparation.
Rapid or precipitous labour is short and quick labour. If you are in precipitous labour, the baby may come fast or take its own time. How quickly your baby arrives depends on several factors. While comparing prolonged vs precipitous labour, fast labour may sound better. While precipitous labour occurs in only 3% of births, it comes with its own set of risks for both mother and baby.
The signs of precipitous labour vary but include the following:
● The start of sudden contractions that are close together, unlike normal labour, where there is a gap between contractions.
● Strong and continuous contractions with no buildup of pain intensity.
● Feels like an urgent bowel movement.
In precipitous delivery, contractions are strong and intense from the beginning, unlike the gradual buildup seen in normal labour. However, in rapid labour, you may have intense and fast contractions from the start. The cause for this is unknown, but some factors can increase the risks.
● Previous delivery
● History of precipitous labour
● The baby is small
● The uterus is good and strong during contractions
● High blood pressure
● Exposed to drugs like cocaine
● Induced labour with prostaglandins
Consult your doctor if you are at risk of precipitous labour so that they can help you take precautions.
Rapid labour happens quickly and happens unplanned, as this is not the birthing experience pregnant women expect. This makes it challenging to handle emotionally and physically. It happens so quickly that even reaching the hospital may not be possible, and it is too late for epidural or pain medication. Other complications are:
● Postpartum haemorrhage or heavy bleeding
● Shock (lack of oxygen and blood to the tissue and organs)
● Risk of vaginal lacerations and perineal tears
● Retained placenta in the uterus
● Delivery in unsanitised places (car)
● Emotional distress
● Not getting medicines for infections like group B strep before delivery.
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● Infection passed from the mother
● Injury due to delivery in unsafe places, like a car seat
● Breathing in meconium
How fast the labour progresses is not in your control, but a few things can be done, especially if you have had precipitous labour previously.
● Keep a hospital bag ready with essential items a few weeks before the due date.
● Pack items like antibacterials, hand sanitisers, blankets, towels, extra clothes and diapers for an emergency delivery.
● Call your doctor immediately
● Stay calm and do deep breathing
● Have someone with you in the last few weeks
● Try to keep the area clean
● Lie down on the left side
If you are a high risk, based on your medical history and various other factors, your doctor may suggest inducing labour. Talk to your doctor about the risks and discuss options if you are worried about precipitous labour.
The probability of precipitous or prolonged labour is less, as most labours fall between these extremes. However, knowing about them prepares you for all outcomes and with support, you can navigate and deliver a healthy baby.
