Have you ever heard of labour stories? Most women will tell you about their long and complicated labour. What about the short and quick ones? Yes, those kinds of labour happen too. While it may sound very welcoming (who doesn’t want to get it over with as soon as possible?), it can also be very stressful. Healthcare providers play a big role in such precipitate births.
Precipitate birth refers to rapid or fast labour. It is when the entire process of birthing, starting from the contractions to the delivery of the baby, does not take more than 3 hours. In general, labour can take anywhere between 6 and 18 hours, with some rare and complicated cases extending over 24 hours as well. In precipitate labour, the woman progresses through the stages of labour very quickly.
The exact cause for this type of labour is still not very clear, as every woman’s body and birthing journey is unique. Some possible reasons for precipitate labour are:
● Not the First Pregnancy – For women with more than one baby, labour can progress quickly.
● History of Rapid Labour – Women with a history of precipitate labour are at a higher risk of experiencing rapid labour again.
● Hyperactive Contractions – If the uterine contractions are strong and frequent from the start, it can lead to precipitate labour.
● Soft Cervix – The cervix has to soften and open up during labour. A cervix that is softer and dilates easily can speed up labour.
● Anatomy – If the mother’s pelvis is wide or if the baby is too small, a faster delivery is possible due to very little resistance.
● Preeclampsia – Women suffering from preeclampsia or high blood pressure may go through labour quickly.
● Placental Abruption – The placenta is supposed to separate from the uterus only during birth. If this happens before labour starts, it can lead to a precipitous birth.
● Exposure – Exposure to drugs like cocaine can also interfere with pregnancy and labour, sometimes leading to precipitated labour.
Contrary to common belief, quick labour does not mean easy or complication-free labour. Some possible complications of precipitate labour are:
● Mentally Challenging – Throughout pregnancy, the expecting mother is prepared for long hours of labour that can be painful and may even need assistance if labour goes on for many hours. Precipitate labour does not give her enough time to get to the hospital in time or do everything she had planned for.
● Bleeding – She can experience heavy bleeding or postpartum haemorrhage, leading to Maternal shock, requiring resuscitation.
● Vaginal Tear – When labour progresses quickly, the risk of perineal tears or vaginal lacerations is high.
● Delivery Area – The delivery can happen anywhere – at home, in the car, or in any unsterilised area increasing the risk of infectoin to mother and baby.
● No Help – She may not get the required medical help in time. In case of complications, she may not reach the hospital or have a fully equipped medical team to help her and the baby.
● Pain – As the contractions occur closer together and progress very quickly, it can be quite painful for some women. The urge to push before she is mentally ready can intensify her perception of pain.
● Trauma – The entire experience can be very traumatic for the mother. She can go into emotional distress or develop anxiety.
● Fetal Distress- Rapid labour can cause oxygen deprivation in baby.
If the mother does not reach the hospital in time, the baby may not get the right after-birth care. This includes proper cleaning, vaccination, full check-up, etc. Though the baby can get all this as soon as they reach the hospital, a delay increases the risk of complications.
Precipitate labour will have symptoms very similar to any labour. It will start with contractions and end with the delivery of the baby. So, how do you know if you are just in labour or precipitate labour? Here are some signs to watch out for:
● In typical labour, the contractions will start slowly gradual increase in frequency of contractions. In precipitate labour, the contractions will start suddenly and will be closer together. Meaning you will not have much time between two contractions.
● The contractions will be continuous and painful. Unlike typical labour, you will not get a break between contractions, and the intensity or pain will not increase slowly.
● In typical labour, the woman will feel the urge to push only when she nears full dilation. In precipitate labour, you will feel the urge to push soon after the contractions start.
Now, how can the healthcare providers help a mother in precipitate labour? If she is already in the hospital and the labour is progressing quicker than expected, the doctor and trained professionals around can help in the following ways:
1. Ensure Safety – The doctor and other health care providers around have to ensure the safety of both mother and baby. This includes keeping a close watch on the progress of labour, anticipating the next step, and being prepared to handle it.
2. Recognising Signs – The doctor should be prepared for a precipitate birth. They should be able to recognise the signs, especially if this is not the mother’s first delivery or if she has a history of rapid labour.
3. Preparation – Unlike regular delivery or labour, precipitate birth requires the entire team to work faster in preparing for delivery. They should not only assemble the team and equipment but also be ready to handle complications and check the baby soon after birth.
4. Manage Delivery – Precipitated birth is when the entire process of delivery happens within 3 hours. So, if the labour progresses very quickly, the doctor should manage the progress without compromising the safety of the mother and baby. This includes postpartum haemorrhage and fetal distress.
5. Immediate Care – They should be prepared to provide immediate care for both mother and baby. This means they should have a paediatrician to provide the baby with the necessary care.
6. Handle Complications – They should be mentally prepared and technically equipped to manage complications such as postpartum haemorrhage, loss of oxygen or consciousness, baby not crying soon after birth, resuscitating the baby, baby not meeting the Apgar requirements, etc.
7. Teamwork – The healthcare providers should work as a team and communicate properly to reduce complications. The doctor and nurses have to work closely in coordination to ensure everything goes smoothly.
8. Counselling – They may need to counsel the mother and the immediate family after the delivery to help them understand what happened and to reassure them about the baby’s safety.
No, labour is entirely unpredictable. In case of a history of rapid labour or signs of fast labour, the expecting mother can get to the nearest hospital without wasting any time. It is always advisable to go to the hospital once contractions start, instead of waiting for them to get intense. While going late can save you a lot of waiting time at the hospital, it can increase the risk of complications.
Rapid labour or precipitate labour is not unheard of. In most cases, it is unpredictable, but with the right healthcare team, the entire process can be safe and controlled. With a well-equipped facility and an experienced doctor on your side, all labour complications can be handled in the best possible manner.
