There’s a term thrown about by those in the birth profession, “Failure to Progress.” Basically, they’re diagnosing a woman in the midst of her labor as being stuck – not moving forward or backward. She’s really trying to have a baby, but the process has stopped.
I get super irritated with this phrase. What do you think happens to a woman in labor when she overhears “failure to progress?” I can’t help but think if she wasn’t stuck before, she will be now! Stuck not only in her body, but also in her own mind with swirling thoughts of, “What’s wrong with me? Why won’t my body do what it’s supposed to?” And what’s happening in her mind has a direct effect on what happens in her body.
The remedy for “failure to progress” is all too often medical in it’s approach: break her bag of waters, give her some pitocin. This approach doesn’t begin to take into account the reason why she’s stuck. If there’s time (and in labor there’s almost always time) why not change things up to see if she could get unstuck?
What’s the lighting like where she’s giving birth? There’s not a woman alive who’s looking forward to giving birth under the bright glare of fluorescent lighting, I promise you! Laboring women are animals. And all other animals require a sense of privacy when giving birth. Usually, animals do best when it’s dark. If the lighting is low while a woman is giving birth, it frees her to say and do whatever will allow her to be in her animal body and not her human brain. Dim lighting enhances whatever rhythm and rituals she chooses to release tension, thereby enhancing her progress.
And how’s the temperature in her space? It needs to be comfortable for her, not the birth team. So that means everyone else better bring a hoodie, because that thermostat will be getting a workout – up and down, up and down! Birth can be hot and sweaty work, especially near the end – but she might feel chilly from time to time. In order to make progress she needs the temperature to be just right.
When was the last time she had anything to eat or drink? I know hospital policies sometimes work against this, and for a woman in strong, active labor eating is usually the last thing on her mind! But giving birth is an awful lot like running a marathon. We’d never expect anyone to complete that endeavor without food and drink to fuel them. Making sure a woman is well nourished and well hydrated throughout her labor goes a very long way toward making good progress.
When was the last time she changed position? Babies really do need their mothers to continue moving throughout labor so they can make all the twists and turns necessary to be born. Gravity always helps in this process – the baby must come down before they can come out. Encouraging a woman who hasn’t changed position in the last 30 minutes or so might be just the nudge that her baby needs to move into a more favorable position for labor progress to continue.
Has she gotten into the shower or tub? Hydrotherapy – a fancy word for using water during labor – has a calming and relaxing effect. And closing the door to the bathroom affords more privacy which allows her to let go even more and move deeper into labor.
But after addressing all of these physical needs – it’s vital that we check in with the laboring woman about her emotional needs. In fact, this might be the real reason why she’s stuck.
Did she and her partner have a fight the night before labor began? Did it ever get resolved? A laboring woman might be thinking: “How can I bring my baby into this disconnected family?” This might seem overblown. But these emotions don’t have to be “rational” to have an impact on a woman’s labor progress.
Who’s in the birthing room with her? Are they helping or hurting her progress? I’ve been at a birth where there were 8 people in the room when the baby was born. The laboring woman spoke of how amazing it was to feel like everyone was pushing with her to bring her baby into this world. But I’ve also been at a birth where one wrong person in the room has shut the whole labor down. The laboring woman was unable to make any progress until the person was asked to leave.
What kind of anxieties does she have about the baby’s health? Or concerns she might have about becoming a mother? This mental anguish can be so powerful that it can bring her labor to a screeching halt.
I know a couple who’d been married for almost 10 years when they finally decided to have a baby. Her home birth was carefully planned out and she had an excellent birth team assembled. But after 3 days of contractions – she still wasn’t in labor. Her midwives thought some privacy would be helpful and asked everyone to leave the couple alone. What happened next was astounding! The woman looked at her husband, announced “I don’t think I’m going to be a very good mother!” and started sobbing. Her husband reassured her, saying she was already a good mother, he acknowledged that he was scared too, and that they would take this parenting thing on together – it was all going to be okay. She had a baby in her arms about 6 hours later!
If we spent as much time checking in with women about their emotional well being as we do her physical well being in the weeks and months prior to giving birth, she might be able to clear her emotional landscape and prevent getting stuck in the first place. If we check in with her emotional needs during the actual labor, create an atmosphere that is physically conducive to giving birth and stop using that awful phrase “failure to progress” – we might be able to get her unstuck in the moment.
Every laboring woman deserves the right physical and emotional space to express her needs so that she can progress in her labor. She should never have to feel stuck.
Did you ever get stuck while giving birth? What helped you to get unstuck?