When labor fails to progress, it is commonly referred to as labor dystocia. Labor dystocia, not to be confused with another circumstance known as shoulder dystocia, occurs often in women from all walks of life. It essentially means that the labor and delivery process is proceeding too slowly, as is evidenced by ongoing monitoring that does not yield progression through the stages of labor. When attempting to identify the source of slow-moving childbirth, medical professionals may find an underlying issue such as cephalopelvic disproportion or a fetus positioned abnormally. Insufficient contracting of the uterus could also play a role in dystocia, which may be addressed with labor-inducing drugs like Pitocin.
Regardless of the source, however, labor dystocia must be recognized and adequately managed in a timely manner. Likewise, it is essential for physicians not to rush immediately to C-section delivery methods, as professionals in the medical community advise against this immediate default option and have recommended lowering the rate of cesarean births among American women. Ultimately, there are a number of possible medical interventions when labor fails to progress, some of which may be attempted before surgical delivery. While in other cases, a cesarean birth is simply the best option and possibly, the only one to avoid placing the pregnant woman and her child in harm’s way. In the absence of appropriate management or eventual C-section, doctors place mothers and their babies at risk for a host of severe birth injuries, ranging from excessive maternal bleeding to fetal asphyxia.
What Normal Labor Progression Looks Like
Uterine contractions are expected to compel and continue the process of dilation, which involves the cervix preparing for delivery. Through dilation and effacement, the cervix stretches and expands to accommodate the baby as it moves through the birth canal. The beginning phase of childbirth, called the latent phase, terminates when the cervix becomes four centimeters dilated, at which point the active phase of labor initiates. The active stage must proceed at a normal rate of dilation in order to ensure successful natural birth. If this is a woman’s first time giving birth, the expected rate of dilation should be a minimum of 1.2 centimeters per hour. If the woman is not a new mother, then the expectation is cervical dilation of at least 1.5 centimeters per hour. Without reaching these necessary benchmarks, a pregnant woman is considered to be progressing too slowly in the birthing process. In these situations wherein labor dystocia manifests, there are various mechanisms and methods to turn the tide and aid the process.
Methods to Address Labor Dystocia and Avoid Injury
With dystocia in labor, treatment generally consists of identifying the source of the slow labor and managing the process from there. With a combination of the various support and practices, the object is to balance the best childbirth practices against lowering the c-section rate, as labor dystocia leads to half of all cesarean births. To lower the likelihood of cesarean, doctors need to be better at preventing, detecting, and managing dystocia. Before resorting to surgery, current recommendations are to allow four hours of contractions, whether induced or natural. Preventing dystocia may be accomplished through not only labor support, laboring at home until the pushing phase, and using epidurals less freely, but also avoiding labor inducement before 41 weeks.
Conscious doctors often attempt to avoid labor inducement at an early labor stage, which is more likely when laboring in the hospital too long. And choosing to induce labor, especially without a ripe or soft cervix, increases the risk of cesarean birth. While a woman is in first stage labor, she should be kept comfortable and monitored. In addition, epidurals in the first stage of labor end up requiring medical inducement and in the second phase, lengthens the pushing stage. In the second stage, the timing of breaking the membranes and administering oxytocin is also critical. Extending the second stage labor time is appropriate if the mother and baby are well and the fetus is moving down the canal. And when a woman has strong enough contractions for minimally two hours without cervical dilation, a physician should usually wait an equal amount of time before surgery.
Also in the second stage, a baby facing the wrong way (facing posteriorly) may cause prolonged labor and eventual cesarean section. Sometimes, a skilled and trained doctor can manually turn the baby to face the anterior position at this point. Certain positions for laboring mother can also help turn the fetus, such as hands and knees or side-lying. As long as the fetus is doing well, second stage labor may still be aided without c-section in certain cases. However, in all stages of management, the laboring patient should be informed and consulted in decision-making. Physicians who miscalculate if and when to surgically remove a baby may negligently cause a woman or her child serious injury, whether it occurs before, during, after, or in the absence of surgery.
What to do if Mishandled Labor Dystocia Results in Serious Harm
Failing to identify labor dystocia or making the wrong decisions about when and how to intervene, may jeopardize a woman giving birth, her baby, and her future family. Mismanagement of labor dystocia has the potential to cause significant injury to the mother and baby, including infant brain damage, fetal distress, hypoxic ischemic encephalopathy (HIE), and intracranial hemorrhage. If your physician failed to handle your labor dystocia, which resulted in injuries to you or your baby, contact an experienced birth malpractice attorney to help assess your options and if justified, file suit on your behalf. Navigating the legal system is daunting without a knowledgeable attorney who can guide you every step of the way.
You and your baby deserve compensation for inadequate treatment and care by the medical professionals you trusted to keep you safe. Our skilled birth injury lawyers can fully look into your potential claim, explain the process involved to recover compensation for you or your loved one, and proceed with a lawsuit demanding the highest applicable damages. This includes medical costs to be reimbursed, such as hospital bills, medications, and rehabilitative therapy expenses already paid, as well as those that will be required in the future. We can likewise recover compensation for lost wages and benefits due to the injury, recovery, doctor visits, and even permanent disability. In addition, your financial recovery can account for pain and suffering, which is often extensive and prolonged in cases of birth trauma. Beyond that, punitive damages are considered appropriate when a medical error is so egregious that the actor warrants financial punishment to deter future similar actions.
Contact our team of dedicated NJ attorneys if you or your loved one suffered injuries due to lack of proper care and management for labor dystocia.
We are pleased to provide free consultations and further assistance to those injured at birth and their families throughout New Jersey. Contact 866-708-8617 to speak with a lawyer regarding your labor dystocia malpractice case and what avenues may be available to you now.