In a birth arrest, there is no further opening of the cervix or entry of the child into the mother’s pelvis. Often, changes in position, relaxation exercises or a walk are sufficient to end the arrest. If this is not sufficient, an oxytocic agent is attached or a cesarean section is performed.
What to do if it doesn’t continue?
A labor arrest occurs when birth does not progress for several hours. There is no clear definition that determines the exact duration of the arrest. The diagnosis is largely at the discretion of the attending physician. Whether a labor arrest has occurred also depends on the circumstances. A major factor is whether the woman has already given birth. In addition, whether the patient has received an epidural (PDA) must be taken into account. Generally, labor arrest is assumed if no progress can be detected in a primiparous woman without PDA in the expulsion phase after two hours. With PDA, the upper time limit is three hours. For a woman who has already given birth to a child, the upper time limit is two hours without an epidural or one hour without an epidural. The health conditions of the mother and the child also play a role. As long as the health of both is good, a temporary birth arrest can certainly be waited for. As an approximate guideline, the birth of a first-time mother should not take longer than 24 hours.
Causes of birth arrest
Birth arrest can have several causes. A distinction is made between arrest during the opening phase and during the expulsion phase, respectively. In a cessation during the opening phase, the cervix does not open further. Possible causes are contractions that are too weak and a fetal head that is too large for the mother’s pelvis. In addition, a so-called positional anomaly may be present; in this case, the position of the child in the pelvis is unfavorable for the birth process. Another possible cause is cervical dystocia, a disorder of the birth process typically associated with labor weakness. Birth arrest during the expulsion phase results in the baby’s head being unable to descend even though the cervix is open. A common cause here is labor weakness. In addition, this complication may occur if the baby is too big. The woman giving birth may also be too exhausted to take an active role during the birth and follow the midwife’s instructions. An epidural may suppress the urge to push, causing a standstill in the expulsion phase. Psychological causes such as anxiety may also be underlying.
What are the signs of labor arrest?
The main symptom of this birth complication is the lack of progress in the birth. If the birth takes a very long time, the uterine muscles become weakened and overstretched. Exactly at what length of time without progress a stoppage occurs is not defined and is decided on a case-by-case basis. Generally, labor does not begin until contractions are strong and regular enough to open the cervix. It is not uncommon for a labor arrest to significantly prolong the birth, leaving affected women exhausted after several hours. In this situation, they are sometimes no longer able to actively assist in the birth. In general, however, this complication is not dangerous as long as the mother and baby are doing well.
At what point is the birth “aborted”
Diagnosis often proves difficult because each birth is unique. Even when there are prolonged periods of no progress, there is not automatically a birth arrest that needs to be treated. If the mother still has enough strength and the baby is not in danger, there is still nothing to prevent a spontaneous birth. Doctors usually diagnose an arrest after two to four hours without opening of the cervix or migration of the baby into the pelvis.
What to do if it does not continue?
Treatment depends on the needs of the mother and the cause of the labor arrest. If the woman giving birth is anxious and tense, a relaxing bath will help in many cases. In addition, changing the birthing position or changing sides every few minutes can help the birth progress. Movement during birth is important because it allows the baby’s head to adjust properly in the birth canal.If the birth stalls, a short walk with an escort is recommended, as this increases labor activity. Contraceptive drugs are used if all measures to promote labor are unsuccessful. Even before the birth, it may be worthwhile to see a specialized physiotherapist to relieve any muscle tension in the pelvis. Such blockages are not infrequently the cause of a standstill during birth. In addition, a childbirth preparation course is important to learn relaxation techniques. A cesarean section is necessary if no measure is effective and the health of the child or the mother is in danger. If the baby has already slipped far into the pelvis, a cesarean section should be considered only in an emergency. In such cases, birth using a suction cup or forceps is associated with fewer complications.
Cesarean section as a last resort
Often, obstetric arrest cannot be prevented. A sonographic examination may diagnose a mismatch between the width of the mother’s pelvis and the size of the fetus. If the disproportion is very large, a natural birth cannot occur. An ultrasound examination may also detect a malposition of the baby. If the baby does not turn before birth, a cesarean section is usually necessary. A healthy diet and adequate exercise are especially important during pregnancy. Birth arrest is less likely if the woman exercises regularly during pregnancy.
