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Can a doctor prevent prolonged labor and its consequences?

If your labor lasted for more than 18 hours after your contractions began, you may have experienced what the medical community refers to as “prolonged labor.” You and your baby may now also live with the consequences of “failure to progress.”

If this is the case, you may wonder if there is anything your doctor or labor and delivery team could have done to sped up your delivery and prevented injuries to you and your baby. In most cases, the answer is yes.

The consequences of prolonged labor

According to Cerebral Palsy Guidance, prolonged labor puts both mothers and babies at an increased risk for serious medical consequences. For the mother, failure to progress—particularly in the second stage of labor (or after the cervix is dilated to 10 centimeters) — increases her risk for obstetric trauma, postpartum hemorrhaging, infections and a combination of health issues.

For the baby, an overly long labor increases his or her risk of developing several health issues. One of the most severe health consequences of prolonged labor is cerebral palsy.

Though the reasons are not entirely understood, studies clearly show a correlation between prolonged labor, brain damage and cerebral palsy. Oxygen deprivation is a major contributing factor, though. When babies get stuck in the birth canal, they experience “birth asphyxia,” which is basically strangulation during labor. The longer a baby stays in the birth canal, the more severe the damage becomes.

Another likely way prolonged birth leads to cerebral palsy occurs when doctors attempt to treat it. To free the baby from the birth canal, a doctor may use a vacuum extractor or forceps. Both these tools, when used with too much force, can damage an infant’s skull by literally crushing it. Understandably, this often results in brain damage.

Treating prolonged labor

Many women experience failure to progress, but with the right care and treatment, a majority of mothers and babies experience little to no lasting complications. If a labor takes an unusually long time, the labor and delivery team should monitor the mother and fetus closely for things like vital signs, fetal heart rate, the timing of contractions, etc. If nothing seems to improve, or if matters grow worse, the doctor should take steps to speed up delivery.

In stage one of labor, a doctor may prescribe Pitocin, a drug used to strengthen contractions and speed up delivery, or order a C-section. In stage two — or when the baby is already in the canal — the doctor should use instruments to encourage the baby out. If the team fails to take reasonable measures to speed up delivery, the family may be able to hold it responsible for resulting health complications.