Labor weakness is the weak or unproductive occurrence of contractions during the birth of a child or their complete absence. In what is called hypo- or normotensive weakness, the state of tension of the uterine contractions (myometrium) is normal, but the contractions are too weak, too short, or too low in frequency. The cervix stays closed longer than it should. Hypertonic labor weakness is when contractions are uncoordinated, although the tension, frequency, duration, and strength of contractions are normal or even increased.
What is labor weakness?
Labor activity may be deficient from the beginning of the birth process (primary weakness of labor) or may decrease as it progresses (secondary weakness of labor). Relatively insignificant for the birth process is a short-lived weakness of labor at the breaking of the amniotic sac or due to the induction of local anesthesia in the area of the parturient’s spinal cord. Primary labor weakness occurs when the excitation of the parturient in the myometrium is locally misdirected or the abdominal or uterine muscles are torn. Other possible causes may be the use of medications during pregnancy or related metabolic disorders. It is quite rare for the pressure of the baby on the cervix and vagina to be less than usual, and therefore not enough oxytocin (“labor hormone”) is released. This can happen, for example, if the baby is abnormally in breech presentation. Also, if the baby is not head-first in the birth canal, but is in a transverse position, the cervix is insufficiently stimulated and thus labor activity is impeded. It is not at all uncommon for the cervix to be open only two or three centimeters even shortly before delivery.
Causes
Secondary labor weakness is manifested when the uterus is overdistended (large child, multiple births, multiple deliveries in quick succession) or when there is an excess of amniotic fluid. Likewise, an excessively prolonged birth or a too small pelvis of the woman can be responsible for it. Often, secondary labor weakness is helped by emptying the urinary bladder and thus relatively uninhibiting the uterus. A sometimes hidden cause of inadequate labor strength could be overstimulation of the uterus. This can be evoked by medications that actually promote labor, painkillers or anesthetics.
Symptoms, complaints and signs
If the due date has been significantly exceeded, also due to labor induction, the mother and unborn child are monitored thoroughly and regularly using a CTG (cardiotocography, “contraction recorder”). This continuously measures the baby’s heart tones and the mother’s labor intensity. Ultrasound examinations are also possible. Transferring the baby from the beginning of the 43rd week of pregnancy is not immediately dangerous at first, but it is associated with some risks for mother and child. Therefore, as soon as any risks are identified, delivery is usually induced. This is very often done with labor-inducing drugs administered by infusion or vaginal gel. In addition, the administration of the labor hormone oxytocin is possible.
Diagnosis and course of the disease
However, in cases of secondary labor inertia, psychological reasons on the part of the expectant mother may also play a role. Temporary labor inactivity is sometimes a way for the heavily pregnant woman to have a little rest and catch some air. The atmosphere in the delivery room of the hospital, hectic pace and hospital routine also occasionally contribute to the slackening of labor. The pregnant woman also has various options for gently reactivating her own labor activity. These range from emptying the bladder (possibly by catheter) to a short walk or light exercise in the fresh air to a warm bath. Depending on the situation and the woman’s state of exhaustion, a light massage, a hot water bottle, some relaxation exercises, acupuncture, a small meal and drinking enough fluids may also help.
Complications
Labor induction does not usually result in major complications. However, for the expectant mother, the extra weeks of pregnancy are a considerable strain, both physically and psychologically, because failing to go into labor always causes anxiety.Especially if labor is absent or very weak well beyond the 40th week of pregnancy, this can be a burden for the woman concerned. Weakness in labor has no effect on the child, insofar as a natural birth can ultimately be induced. There are certain risks involved in the treatment of a weak labor. Occasionally, the home remedies used to speed up the birth process cause discomfort. Essential oils can irritate the intimate area, while ginger or clove oil sometimes cause allergic reactions. The administration of labor hormones can throw the body’s own processes out of balance, causing an opposite effect – labor starts even later. Supportive means such as forceps or a suction cup always carry the risk of injuring the mother or child. A cesarean section is also associated with the risk of injury, but wound healing problems or infections can also occur.
When should you go to the doctor?
Women who discover that they may be pregnant should always consult a doctor. The course of the pregnancy as well as the subsequent delivery should be monitored and planned in time. In addition, the expectant mother should obtain timely and comprehensive information about the upcoming changes and possible developments during pregnancy. In particular, the physical development process should be brought to light so that surprises can be avoided and consultation with the attending physician can be sought immediately in the event of abnormalities. In the final phase of pregnancy, labor usually begins around the time of the expected delivery date. It should therefore be clarified and planned in good time where the delivery is to take place. When giving birth, it is strongly recommended to use trained medical personnel. If there are any peculiarities during the birth process, they can act immediately. With the onset of the first contraction, the nearest hospital or birth center should be visited. Alternatively, if a home birth is planned, the midwife should be informed. During the birth process, labor is monitored by the obstetricians. Their instructions should be followed to minimize possible complications. In case of sudden pain in the abdomen or absence of menstruation for several months, a doctor should also be consulted.
Treatment and therapy
For the massage, for example, ten milliliters of almond oil is drizzled together with two teaspoons each of ironroot oil, ginger oil, clove oil and cinnamon oil. When the pregnant woman’s abdomen has then been moistened with warm water by herself or her partner, the fine oil mixture is gently massaged in. Its components all stimulate the muscles of the uterus and thus promote labor pains. Essential oils and herbs (cinnamon, cloves, ginger) can be added to the warm bath according to personal taste. However, a person should always be nearby during this warm bath, because depending on the state of the circulation, the labor rhythm can intensify very quickly on this occasion. If the pregnant woman is still at home, sexual intercourse is also a suitable means of stimulating labor, provided it is possible and desired in the specific situation. Sexual arousal is said to be able to release the labor hormone oxytocin. In addition, male sperm contains tissue hormones, which are also used in induction of labor by medication. They can enlarge the cervix and relax the uterine muscles. A tea with labor-inducing ingredients such as cinnamon, ginger and verbena, drunk lukewarm throughout the day, has similar effects. A few cups of raspberry leaf tea also serve this purpose in a very healthy and encouraging way. If the contractions still do not get going and medications do not help as desired, supportive devices such as a vacuum cup or forceps may be used at a crucial stage of labor. The doctors and midwives will then, with the mother’s consent, also have to decide on a Caesarean section at the right time if necessary.
Prevention
Since the entire birth process is individual from woman to woman and labor weakness occurs sporadically, it can accordingly not be prevented.
Aftercare
Labor weakness is a complication that occurs only during childbirth.Otherwise, it does not lead to any adverse effects. Therefore, no separate follow-up measures are usually necessary due to this birth complication. However, regardless of the weakness of labor, some postpartum examinations are generally recommended. In a few cases, this birth complication is a so-called primary weakness of labor, which may have genetic causes. For the women affected, it can be quite helpful to have further follow-up examinations performed by a gynecologist. This is particularly advisable if the patient has already experienced a weakness in labor during previous births or in her immediate family. However, such examinations are only useful if further pregnancies occur or are planned. The weakness of labor does not have to be examined directly after the birth. This can also be done as part of further prenatal care. A closer investigation into the causes of labor weakness is generally helpful above all so that the affected women and the gynecologist can adjust to it in future births and respond to it in time. Otherwise, however, primary labor weakness does not cause any symptoms and does not need to be treated.
What you can do yourself
If labor weakness is present, it is essential for the affected woman to seek medical treatment. Self-help measures alone are usually not effective. Nevertheless, there are some methods that can gently stimulate labor activity and ease the situation. The first measure that can lead to an improvement in many cases is emptying the bladder. In consultation with the attending physician or midwife, other self-help methods can be taken. Exercise often has a beneficial effect on labor pain. For example, short walks in the company of another person are recommended. In some cases, gentle yoga exercises can help to overcome the weakness of labor. In general, it is recommended to adopt an upright position. In addition, a bath with warm water can have a positive effect on labor. Additional light massages and acupressure are helpful. In case of severe exhaustion, it is recommended to sleep for some time. In addition, affected women should eat something. Dextrose also has a supporting effect. Adequate fluid intake should be ensured. The affected women should try to relax as much as possible. Certain breathing techniques can contribute to this.
