What makes dilation stall?

I recently heard a birth story from a friend who said that her labour stalled at 8cm. She remained in transitional labour for 3 hours or so, with no progress. Eventually they did a c-section. This was an induction, with a posterior baby - her first. (Brutal introduction to motherhood!) She says she will NEVER go through labour again, because the experience was so awful.
Does anyone have any suggestions as to what makes this happen? Why does dilation stop? What can help? What can keep this from happening again? Is it just because this was an induction? Or because of the baby's position? Any opinions will be welcomed!
Thanks! :)

My labour stalled when I was pushing, although I had only just started pushing really.

I put it completely down to the hospital staff bullying me. When you're not in safe environment your body will fall out of labour because you need to be safe to birth. Look at every other animal - they find a safe place. Why do we humans then create the least safe place possible to birth and coerce the populance into going to that place?

Ryn, did your contractions stop? I've heard of the body taking a rest after transition, especially, or turning off labour when you're tense (mine did that to me with DD3) but my friend's contractions kept going, strong and hard - just no more dilation. Do you think it's the same sort of thing?

I stopped wanting to push and the lovely machine told everyone that my contractions were erratic and calming down - as soon as the syncto went in (I had no choice here, they were doing it no matter what I said) then my contractions started again - with what was your friend induced? But it wasn't until I had calmed down that I was able to push again.

I'd be interested to know too Cricket. A good friend of mine stopped dilating at about 8cm too and was in transition for a few hours. They then gave her the drip, but she still didn't progress and ended up with an emergency c/s. How do we know that it won't happen again?

i was slow to dilate during first labour due to being tense and scared. i was still getting really painful contractions the whole time. actually now that i think about it i was induced and bub was posterior also. so i would say those two factors probably do have some part in it. (this was early on in labour though, not at transition)

I also think fear etc can have an effect. Not feeling safe or comfortable etc

It happened to me. I have only had one labour. It started naturally and like lots of first labours took a few days to work up to needing to go to hospital. by then I was 3cm and progressed at a "normal" rate to 7cm then 7 to 8 was quite long and then could not get past 8. So they used syntocin but still took a long time to get to 9 cms and I don't really know if I got past this as DD became distressed and we needed an emergency c/section.
I felt supported and was not scared. (I work in a hospital so don't find them scary places). I was 40 and a few people say that labour can stall when you get older but I have never actually read any evidence of that.
I was told there was no reason it would happen again and was encouraged to birth naturally again but miscarried so did not try it again.

I'm pretty sure the position of the baby can make a difference too, especially if it was an induced labour, and the cervix was possibly not quite ready.

I was induced with AROM, then the drip (also had an epi about 6 hours in) was in labour for 10 hours but never progressed past 4 cm. end result ECS.
For some reason once they started the drip, my contractions slowed down, I was also really ***** scared of the drip and that was when I said I wanted the epi.
bub was also posterior, but I think for me it was a combination of not trusting the people around me, being scared, and not having the belief that things were going to happen naturally, I was told straight up that I would almost definately be having a Csection- but hey we will let you experience labour so you dont feel like you are missing out :rolleyes:
I really think the epi stalled things too, thats pretty common, but im guessing your friend dint have one?

Unfortunately labouring with a baby in the posterior position mainly with a first time labour often women do get to 8-9cm dilated and then the last little bit wont go so a c/s is performed hours after being stuck at the same dilation. When an epidural in is use unless its one where you can be mobile even with synto it can be very hard to assist decent and rotation of the baby due to being stuck on the bed. You can try rocking the pelvis, being on all fours and a variety of other positions to aid with decent and rotation to help with dialtion but sometimes nothing works even with time there is no change. When the baby is posterior the part of the skull that presses on the cervix and helps it open up isn't as effective and a funny shape in comparison to the part that presents when its anterior (the most common and easiest way). When the baby is coming anterior (back of the skull seen first when crowning) its much more effective then when the forehead is presenting (posterior). Thats why birthing with a posterior baby is often longer and pushing is harder to get them out.
When a lady has birthed vaginally before the birth passage opens easier because its being used before and the cervix stretches more effectively and most of the time a woman birthing for the 2nd, 3rd etc time will not have much difficulty when the baby is posterior.
In the hospital setting it is not that common unfortunately for women birthing for the first time to have a direct posterior baby to not have assistance ie forceps, vacuum, episi, synto or c/s. Of course it does happen with no assistance and I have seen many but most medically based facilities have time limits and do intervene for a variety of reasons. I would guess its over 50% that have medical assistance.
I can understand your friend never wanting to go through what she has again and electing for a c/s next time. There is no reason the same thing will happen next time especially if her next baby is coming anterior. Me personally being a midwife I wouldn't take the risk either of perhaps it happening again and having another emergency c/s even when statistics are in favour of VBAC.

I forgot to add that if your friend wasn't induced then there was every possibility that her baby would not have being posterior or in a better position for birth. Because your inducing labour when the baby and the woman's body isn't ready to be born or birth the likelyhood of c/s is much higher.

I was going to say the same as Emmy, posterior presentation can have an effect on the progress of labour - it can be very erratic with labour (and dilation) stopping and starting. My girl was sitting posterior for awhile and early labour started then stopped again and NOTHING happened for over a week. She flipped around before I was induced, but I could suggest it was a similar thing at play with your friend - the head not putting pressure on the right muscles to help dilation continue.

When my best friend was in labour, she dilated a whole 3cm's and then stopped.. they left her 3 days and she had a horrible labour, contractions didnt stop. finally they sent her in for a c-section and she is now terrified of going thru that again & said if she was too, she would be going for an elective c-section as her recovery was a hell of alot longer.

they never told her why she didnt dilate any further. poor girl :(

:

---

Thats why birthing with a posterior baby is often longer and pushing is harder to get them out.
When a lady has birthed vaginally before the birth passage opens easier because its being used before and the cervix stretches more effectively and most of the time a woman birthing for the 2nd, 3rd etc time will not have much difficulty when the baby is posterior.

---

my second was born posterior and it took me twice as long to push her out. i didnt think she was ever going to budge

I would absolutely agree with Lulu on the fear part of it.... Did something change for her at that point in time? Something she may not have realised would affect her so much?

This exact thing happened to me & I can pinpoint exactly where it went wrong. I was at 9cm with Alexzander & everything was going perfectly. I had been in labour for 29 hours at the time (had the drip & epi in for 4 hours by then) and everything stopped, I remained at 9cm for another 7 hours until I was given a c/s. I put it entirely down to a midwife change over. I was very comfortable with the midwife I had, she was there with me from 7am to 7pm and just was not allowed to stay with me anymore, as it was she had already stayed 4 hours over her shift at that point. When she left it stalled. I was at ease with her & the next midwife I didn't click with. I hadn't realised it at the time, but a while afterwards I figured it out.

Baby's head can take a while to mould for some also.

Interesting I was at 6cm when went into hospital and at that point DD was assessed as being anterior, I never progressed from there despite synto and epi being given after about 5 hours of no further dilation (cervix was just get red and irritated they said), ended up in emergency c/s and DD was found to be posterior. So it could be that she turned shortly after I arrived in hospital and that is why it stalled - I was still having contractions but no dilation and I think after about an hour in hospital the contractions changed a little and didn't feel as effective and just hurt more.

Dialation can stall due to the presence or influx of catecholamines - a stress hormone which puts the body in a state of fight or flight - and can stop a woman's contractions altogether.
Given that she was artificially induced before labour had the chance to start when nature intended, it is also likely that her body simply wasn't ready for labour, and this is why so many inductions end in complications and ultimately a c-section - the body simply says "No, this was not my plan - listen to me, not the guy in the white coat!"

Thats terrible that she now fears birthing naturally again. I'd recommend she read Henci Goer's book The Thinking Woman's Guide to a Better Birth - it explains in great detail why births which begin with intervention have a much higher risk of ending in intervention, and why allowing labour to start naturally is the safest and easiest way for the body to birth.
Although she may not want to consider it at the moment - birth trauma does fade over time and the experience is still very raw in her head so its only natural that she feels defensive about that. But the facts are that 2nd labours are renowned for being easier than the first - the body simply knows what to do - especially if it is permitted to start naturally.

I hope that with time, and the right sort of information, she is able to have faith in her body enough to try again.

X

DD was not posterior and my labour stalled at 7cm and was even told by the midwife that she thought I was going backwards! This was in a Birth Centre and I was very comfortable, no fear, nothing changed etc to 'cause' it to happpen. I was transferred to a hosp and told by diff obs and drs that it is not uncommon in a first labour for this to happen and most unusual in subsequent labours and I have even read into it online and saw it in the very general What the Expect when you are Expecting book. So I can't answer the original qu- 'What causes it to happen' but just wanted to add my bit and that it is not unusual!

The funny name for your friend's labor pattern was a Posterior Arrest. The mother is not a jail, however. Releasing the baby means releasing the mother, too. By this, I mean, that often tight or twist pelvic floor muscles can hold a baby back at 7-8 cm for many hours.
If we can do a technique to release the tension on those muscles, the baby may be able to either rotate to a better postion (anterior, with its smaller head circumference) or simply suddenly have room to come out
An inversion and a pelvic floor release are two things that can be tried. See About Spinning Babies for a free education on Posterior presentation or other tricky fetal positions.

It doesn't have to repeat. Second babies are worth it!

This happened to me. Induced labour, posterior bub and only 3 or 4cm dilated.

I was told that the baby's head pushing on the cervix helps it to open and this doesn't work as well when bub is posterior. My bub got stuck and I was told that is why I didn't dilate any further.