Dystocia - Reason for Cesarean?

Posted by Brenda Lane Aug 6, 2007

A review published in the American Family Physician highlights the challenges faced by mothers in labor with their first babies who have failure to progress.

According to these Massachusetts reseachers, at least 50% of primary cesareans are performed on the first-time mother who is experiencing a "failure to progress" in labor. This failure to progress or "dystocia" can have many causes including ineffective contractions and the position of the baby.

Researchers in this review recommended that before physicians do a cesarean due to dystocia, that mothers should be given several hours of pitocin to make sure she has effective contractions. In addition, allowing the mother to push for "longer than traditional time limits" if the baby' heart rate is reassuring and the baby's head is descending.

They also recommended the use of trained labor support companions (birth doulas), waiting until the mother is in active labor to be admitted to the hospital, avoiding inductions until 41 weeks and "using epidural analgesia judiciously."

This is a very interesting study and further demonstrates the benefits of encouraging the natural course of labor as well as the measurable advantages of doulas to the laboring mother.

For related information see:

Questions to Ask Your Provider

Long Labors and What to do

When to go to the Hospital

Brenda