Failure to Progress in Labor

Failure to progress is used to describe the inability to deliver a baby vaginally. Though there are different criteria to define failure to progress, the end result is the same—some type of intervention is necessary to deliver the baby.

Defining Failure to Progress

Some health care providers define failure to progress only when the pregnant woman is in active labor, meaning that the cervix has opened three to four centimeters, and that it has thinned (effacement). Indications of a failure to progress might include:

• Despite full dilation, no significant movement of the baby into the birth canal after 3 hours of pushing
• Fewer than three contractions in a ten minute period, each less than 40 seconds long
• Less than one centimeter change in dilation per hour for at least two hours

There can be any number of causes, including weak contractions (often through no fault of the mother), a baby with a large head which cannot pass through the birth canal, the size and shape of the mother’s pelvis, or a posterior presentation (where the baby’s face is in the same direction as the mother’s). It is especially important in a long labor for doctors to use electronic fetal monitoring to check for signs of fetal distress, and to be prepared for an emergency cesarean section.

Reacting to Failure to Progress

In order to move the baby closer to delivery, physicians have a number of options. Some possibilities include:

• Artificial rupture of membranes: the “breaking of waters” can occur naturally or it can be accomplished manually by a physician. Rupture of membranes is one step toward speeding the delivery along.
• Oxytocin/Pitocin/Cytotec: drugs like Pitocin, Oxytocin and Cytotec can be used increase contractions.
• Cesarean section: particularly where the baby shows signs of distress after a long labor, it may be necessary to perform an cesarean section. Children who do not receive a timely cesarean section may be at risk for cerebral palsy and developmental delays.

Contact Us

Our birth injury lawyers have experience reviewing medical records and determining whether physicians and other health care providers should have reacted differently to signs of a laboring mother’s failure to progress. When those failures cause birth injuries, the parents and child may have claims for medical malpractice. Call us at (440) 252-4399, or send us a message through our website.