Prolonged and Arrested Labor
Labor is the natural process when the uterine contractions result in progressive dilation and what is known as effacement of the cervix. Effacement means that the cervix stretches and becomes thinner. Dilation simply means that the cervix opens up. Normal labor progresses slowly. When the cervix is dilated for more than 4 cms, the active phase of labor usually begins then. During active labor, the cervix would progressively dilate at the rate not less than 1.2 cm per hour for a first child and 1.5 cm for subsequent pregnancies and deliveries.
When a mother’s labor progresses slower than prescribed, a woman may be experiencing an arrest of labor. Arrest of labor is simply the absence of progress in the dilation and descent of the newborn down the birth canal. If there is no progress for at least two hours, then arrest of labor is in place.
Labor is said to be prolonged when the first and second stages of labor together is longer than 20 hours for a first pregnancy and greater than 14 hours for subsequent pregnancies. Prolonged labor is more common in a first pregnancy and in women who are over the age of 35.
Causes of prolonged and arrested labor are varied. Some of them are related to the presentation of the newborn:
- Breech position in which the baby’s bottom is in the down position.
- Face presentation in which the baby is facing the mother’s abdomen.
- Deflexed position of the head where the baby’s neck is less flexed.
- The baby’s head is positioned first in as tilted to the shoulder causing the baby’s head to no longer be in line with the birth canal.
Prolonged and arrested labor can also occur when the size of the baby’s head is larger than the size of the mother’s pelvic passage or birth canal. Other problems such as inadequate uterine activity are a common cause of prolonged and arrested labor. This would be common in a twin pregnancy. Inadequate contractions are treated with uterine stimulation, usually with Oxytocin or Cytotec. However, overstimulation or too much of these drugs can cause excessive and traumatic contractions that may injure the baby. When it is noted that five contractions every ten minutes occurs, the stimulation drugs are stopped.
The risk of prolonged and arrested labor include fetal distress due to the lack of oxygen to the baby, bleeding inside the baby’s head, and increased possibility of the need for a Cesarean section or forceps or vacuum extraction procedures to deliver the baby. The long term risk of harm to a baby who is born after prolonged and arrested labor is cerebral palsy and hypoxic ischemic encephalopathy (HIE).
There are also risks of injury to the mother which include intrauterine infections, cervical tears, postpartum hemorrhage and postpartum infection.
Diagnosing prolonged and arrested labor can be made by the timing of the duration of the labor, frequency and strength of contractions and whether labor is normal according to the three stages of labor.
If you or someone you know have experienced prolonged or arrested labor and you or your child has been diagnosed with permanent injuries, please call us for an immediate free consultation. Robert Kreisman of Kreisman Law Offices has been handling Chicago and Illinois boating cases for more than 40 years.
Kreisman Law Offices has prevailed in trials and settlements in Chicago, Illinois and surrounding areas and successfully resolved cases for severely injured clients for over these many years.
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