Abnormal labor is a broadly-defined condition that can indicate a particular part of the labor process is not occurring under normal circumstances. Under normal circumstances, labor progresses at a certain speed, but with abnormal labor the speed may either slow down or speed up.
Labor can be dividided into three stages, first, second, and third stage.
First stage of labor
The first stage of labor begins with contractions and changes in the cervix and it ends when the cervix is fully dilated. The first stage can be further subdivided into:
- latent phase which is is characterized by gradual cervical change
- active phase which is characterized by rapid cervical change (at least 1 cm dilation per hour).
Second stage of labor
The second stage of labor begins with complete cervical dilation and ends with the delivery of the baby.
Third stage of labor
The third stage of labor begins with the delivery of the baby and ends with the delivery of tha placenta.Many times, the labor process may begin in a completely normal fashion but transition to or develop abnormal circumstances quite rapidly. Most often, the contraction and dilation process may change or even regress or stop alltogether, which alerts the physician to consider an alternative course of action for delivery. While this condition is not necessarily foreseeable in many deliveries, knowing what may happen in the event your labor process becomes abnormal is definitely advised.
- Prolonged latent phase
- Protracted active phase
- Arrest of labor
- Precipitous labor
- Protracted descent (fetal head)
- Arrest of descent (fetal head)
Causes of Labor Disorders
A prolonged latent phase is the most common cause of abnormal labor. Depending on the mother, a latent phase lasting more than 14-20 hours is considered prolonged and will indicate an abnormal labor process. Other causes include low uterine contraction power and the size difference or ratio of the pelvis and baby. Low-dose epidurals can be to blame for an abnormal labor, as they may impede the power of the contraction process which will increase the amount of time one is in labor. Internal issues with the baby, such as any condition that may temporarily increase the size of the baby due to inflammation and swelling, will also delay the process, resulting in abnormal labor.
A diagnosis of abnormal labor is made based on the conditions of the specific labor process relative to what is considered to be a normal labor process. Observations of varying contraction frequencies, cervical dilation and overall time in labor are the biggest considerations made as to an abnormal labor process, along with a plethora of other factors if present. This complication is defined as a deviation from a normal labor process, so there can be any number of issues that contribute to a normal delivery and labor process being an abnormal one by definition.
Typically, when an individual is undergoing an abnormal labor process, the physician will further evaluate the individual to determine what phase the individual is at in labor. For those who are in the latent phase, rest is advised in order to preserve energy for when the mother enters the active phase of labor. Approximately 85% of pregnant individuals will enter the active phase of labor on their own through this simple process. In the other 15% of cases, either there will end up being a diagnosis of false labor or the individual may be medically induced into having a child via oxytocin.
The short and long-term prognosis for individuals dealing with an abnormal labor process is good. The large majority of cases is properly dealt with and goes on to deliver healthy, happy babies. Issues that can arise during abnormal labor include a rupturing of uterine membranes that lead to chorioamnionitis, a bacterial infection. Some abnormal labors are brought on by circumstances such as a contracted pelvis and are likely to reoccur in future pregnancies, while other issues such as macrosomia (large baby) may not reappear in future pregnancies. If you are having complications during labor, communication with your doctor is crucial in discovering what exactly is causing the issue and whether or not it will be a future occurrence or an issue for your baby.