The slow to start laborLet's begin by defining the slow to start labor. We are not talking about being overdue or past date. We are talking about the labor that seems to be trying to start, but isn't really picking up any steam. Maybe the mother has been having contractions on and off for a few days, or has been having contractions for several hours with no change in their length or frequency.
Because the labor and birth process includes many changes that happen in the body, it is impossible to know why a particular labor is slow to start. Even if you did know the reason for the slow labor, there may be nothing you can do to speed labor. The best you can do is to make good decisions about how to handle the situation you are given. If possible, try to eliminate causes by working through some of the suggestions below.
Hormone Levels Not Read
One reason a labor may be slow to begin is the hormone levels have not had a chance to properly adjust yet. It is the change in progesterone and estrogen levels that make the uterus sensative to oxytocin in the body. If the hormones have not adjusted yet, even artificial oxytocin (Pitocin) will not be effective at begining contractions. There is no way to be certain a slow to start labor is caused by hormones levels that are not yet adjusted.
Because this situation prevents the uterus from responding effectivly to oxytocin, even using artifical stimulation of contractions may not be able to start your labor in a reasonable amount of time. Some women have found that thumb sucking or stimulating other accupressure points can be effective at speeding laor. If all other options for causing a slow to start labor have been exhausted, the mother may simply need to give her body the time it needs to adjust the hormone levels.
Cervix Not Ready
Another thing to consider the is state of the cervix. In response to hormonal changes, the cervix begins to soften so it can be stretched and opened during contractions. If the cervix is not "ripe" it cannot be opened by even the strongest contractions. Your body may need more time to wash the cervix in prostaglandins (compounds that soften the cervix) to allow it to stretch).
Because the cervix will respond to prostaglandins, it is possible to speed up this part of labor preparation. There are artificial compounds that can be placed on your cervix in the form of a cream that will soften the cervix and cause contractions to begin, however because it is a cream it can be difficult to control the dosage of prostaglandins if you get too much.
A natural source of prostiglandins is semen, which you can get freely and even plesantly from your partner. However, you are not garunteed that these prostiglandins will reach the cervix or have any effect.
Poor Postion of Baby
Some slow to start and slow moving labors are caused by the baby being in a poor position on the cervix. When this happens, the baby's head is not able to put equal or adequate pressure to the cervix and so even powerful contractions are not effective at opening the cervix. This is refered to as an asynclintic position.
The best remedy for an asynclintic position is to change positions, particularly in ways that allow the pelvis to move. It may be smart to try lunges with one leg up on a chair or one-legged squats for a few contractions to see if this allows the baby enough room to slide into a better position. Walking can also be very effective at helping the baby get into a good position.
Some undesirable ways to handle this would be by artificially stimulating stronger contractions, such as with pitocin or cervidil, as these stronger contractions may cause the baby to become wedged into the pelvis in the bad position. Another undesirable way to handle a poor position is with the use of an epidural block. This medication will prevent the mother from moving her legs and pelvis and therefore make it more difficult for the baby to move into a better position.
Mother Not Emotionally Ready
Under the category of "strange but true" is the fact that mothers have more control over their labor than they know. When a woman is unsure of her ability to be a mother, fearful of the labor process, or simply doesn't feel ready to labor, her body can send chemical messages that block the labor process from starting. This is the same process that causes the Fear - Tension - Pain cycle.
It is important that the mother be honest about her fears and concerns so that her labor support can help her through any doubts she may have about becoming a mother. This is very difficult to deal with once labor has begun, but sometimes it is necessary for the mother to speak these fears even after labor has begun.
Dehydration can bring on pre-labor contractions. One of the first things you should do when you think you might be in labor is to drink at least a sip of water between each contraction. Dehydration can also cause contractions that look very similar to labor, but will not make changes to the cervix. If, after several hours of a contractions that look as if they should be productive, it is determined that the cervix has had very little or no change, review the amount of water and ice chips the mother has had.