If it is found that the labour is not progressing as expected, what then?
The main focal point of a slow labour is whether the contractions are strong enough.
More often than not, in such cases, they will not be. If this is suspected to be
the case, two courses of action are possible.
Firstly, if the membranes are still intact, the waters may be broken. This may have
the effect of increasing stimulation of the uterus, resulting in stronger contractions.
The second alternative is to give the mother an intravenous infusion (drip) with
the hormone oxytocin. This directly stimulates the uterus to contract more strongly.
It is important to remember that weak contractions are not the only cause of poor
labour progress and it is up to the attending obstetrician to make correct analysis
and institute the right corrective measure.
If, in spite of corrective measures labour still does not progress, what can be done?
If labour stalls in the first stage, in spite of corrective efforts, then the doctor
will have to resort to a caesarean delivery. He or she may then investigate postnatally
why labour never progressed. Even then, the causes may still remain a mystery.
There is a widespread belief that using pethidine or diamorphine (for pain relief)
may actually cause contractions to weaken or stop altogether. Is this true?
There is no truth in this. Weakening of contractions is usually a figment of the
imagination, brought about by the blunted perception of the pain and the sedative
effect of these drugs.
Does epidural analgesia weaken contractions in labour?
No, it does not. It is still true, however, that the second stage may be prolonged
because of blunting of the urge to push.
Is there any merit in remaining mobile during the first stage of labour?
Yes. There is evidence that walking about may somewhat reduce the distress of the
pain in the first stage, by giving the mind something else to concentrate upon. The
shortening of labour is an unproven benefit.
Can one have an epidural and still be mobile?
This is occasionally possible. However, this will have to be a ‘light’ epidural,
so as not to deaden the limbs. It is also essential that there is the continuous
presence of an assistant - be it a midwife, the partner or another responsible adult
- whenever the mother is walking. This is to ensure her safety.
Can I have a meal or at least a snack during labour?
This is not a good idea. Firstly, the labouring woman is unlikely to benefit from
eating, because hardly any absorption is taking place from the stomach.
Secondly, vomiting is rather common in labour and this can be quite distressing,
especially after a meal. This takes on particular significance if a surgical procedure
under a general anaesthetic (such as a caesarean section) becomes necessary.
Vomiting of semi-solid food can be dangerous in this state of unconsciousness as
the stomach contents may be aspirated into the airway, creating a dangerous complication.
Sips of non-acidic drinks, plain water or sucking on ice is OK to relieve mouth and