It isn’t uncommon for labour, particularly a first labour, to be labelled as ‘slow’. This can come with all sorts of additional pressures and difficulties.
Firstly it is hard to define slow progress because everyone is so different and every labour journey will be different. Additionally it is hard to evaluate labour progress as things can change so quickly and it isn’t always easy to monitor progress reliably. Although cervical dilation is the commonest we know that contractions might be doing other things – helping baby move, soften or thin the cervix – which don’t always show up so easily or as measurably.
So a slow labour can mean pressure to do something to speed things up, this might be a suggestion of breaking waters or using syntocinon to ‘augment’ labour and encourage stronger more regular contractions. Both of these options need to be considered carefully to ensure you feel it is the right approach for you as both will have pros and cons which you need to factor in to your decision making.
Additionally a slow labour can bring challenges to your coping techniques and your ability to manage your contractions over a longer period of time.
It is really important to remember that a slower labour can be normal and doesn’t necessarily mean there is a problem to be fixed. It could be that baby needs time to move into a better position or that the muscles are getting tired or maybe the woman is stressed or anxious, maybe she already had some medication that is affecting her progress. Or maybe this is just normal and perfect for her and her baby. Anecdotally there are stories of a slow labour and it turns out the cord was knotted restricting blood getting to the baby and a more stressful, intense labour would have been more risky; our bodies know just what to do.
Having coping techniques will help lots you if your labour takes time. Often you will be at home managing and this can be hard if you are feeling tired or getting anxious about your progress. Some people like to go to hospital to be checked and get some reassurance but this can be problematic if you are encouraged to stay too early. You usually are better in your own environment. Most maternity settings will only admit you to the labour ward or birth centre when you are 4cm dilated and before that if you stay you will usually be on an antenatal ward which isn’t an easy place to relax but if you feel that you need pain relief might be something to consider.
One of the tricky things is finding your balance. Lots of the advice around speeding up labour or keeping things moving involve keeping you moving! And if your labour is slow you could be trying to stay upright and active for hours and hour with little sleep. All of which isn’t very conducive to labour progress.
You need to find the balance between activity and rest. If you are tired your body will struggle to keep going physically and contractions may lose their strength but also your adrenaline will be rising and that is not helpful when it comes to labour progress. You might really want to keep active to try and get things moving but there are times where the best option is definitely to have a rest, try a nap or just find a comfy position where you can relax, close your eyes and give your body chance to recover some energy.
So what will help you?
Oxytocin
Oxytocin is the hormone that makes contractions happen and there is lots you can do to boost your oxytocin.
Think about your environment, are you somewhere you can relax and feel safe? Could you dim the lights? Get rid of excess people? Play some music? Use scent to focus you?
Boost your oxytocin with massage, nipple stimulation or even sex/orgasm. Oxytocin levels are high when you feel loved and safe.
Your birth partner can focus on lots of the oxytocin elements so you can switch off and let yourself fall into your labour. Let them know how you want your space set up and what support you need.
Snacks
Are you looking after yourself? If things have been going for a while you might need to up the snacks and drinks to ensure your body is hydrated and has enough energy to keep working efficiently. You probably won’t feel like eating too much so have snacks to hand that will give you a quick boost. You might got for sweets or protein balls or even a spoonful of honey. You could use your drinks for an energy boost too with coconut water or fruit juices.
Gravity
The reason that upright and mobile positions matter is gravity. If your baby’s head is making good contact with your cervix then more oxytocin is released and progress is better. In order to make that good contact your baby needs to wriggle into the best position and keeping your pelvis moving can help them find the space to do that and gravity will also help them to descend.
You might try walking up and down stairs sideways like a crab. Or, if you are at home, walk up and down the road with one foot on the pavement and one in the road so your pelvis is a bit lopsided.
When you need to rest a peanut ball between your legs as you lie on your side can be a great way to encourage your baby into a good position while you rest.
De-stress
If your labour is a bit slower moving it is quite possible you have some people on your case. Maybe a few extra vaginal examinations, people popping and out to see you, monitoring for baby, questions, conversations (which may or may not include you!) and just generally disturbance. All good if you need to make sure everything is ok but it can be really distracting and unsettling to have all this going on around you when you really need to switch off and chill.
Try and zone out from the noise, let your birth partner take the strain here, ask people to leave the room or take their conversations elsewhere and then use your tools to get you back on track with your breathing and movement.
Wait
Not as crazy as it sounds. Often labour is happening just fine. Slowly, but fine. We are in a time of hurry, of looking for problems and jumping in to fix them. If you and baby are both ok then there is no problem with waiting and seeing what happens. It might be that you just need to take it a bit slower and left to it, you’ll get there.
And if you decide this isn’t happening, maybe your gut instinct tells you this isn’t right or you are starting to struggle, then it might be that an intervention to get things happening is the right thing for you. But be sure to get the information you need to make that decision and think about the bigger picture of what is going on around you.