There’s a term thrown about by those in the birth profession, “Failure to Progress.” Basically, they’re diagnosing a person in the midst of their labor as being “stuck” – not moving forward or backward. They’re trying to have a baby, but the process has stopped.
I get super irritated with this phrase. What do you think happens to a person in labor when they overhear the phrase, “failure to progress?” I can’t help but think if they weren’t stuck before, they will be now! Stuck not only in their body, but also in their own mind with swirling thoughts of, “What’s wrong with me? Why won’t my body do what it’s supposed to do?” And what’s happening in their mind has a direct effect on what happens in their body.
The remedy for “failure to progress” is all too often medical in its approach: break the bag of waters, hook them up to pitocin. This approach doesn’t begin to take into account the reason why they might be stuck. If there’s time (and in labor there’s almost always time) why not change things up to see if they could get unstuck?
What’s the lighting like? There’s not a person alive who’s looking forward to giving birth under the bright glare of fluorescent lighting, I promise you! Laboring people are like animals. And all other animals require a sense of privacy when giving birth. Usually, animals do best when it’s dark. If the lighting is low while a person is giving birth, it frees them to say and do whatever will allow them to be in their animal body and not their human brain. Dim lighting enhances whatever rhythm and rituals they choose to release tension, thereby enhancing their progress.
And how’s the temperature? It needs to be comfortable for the laboring person, not the birth team. So that means everyone else better bring a hoodie, because that thermostat will be getting a workout – up and down, up and down! Birth can be hot and sweaty work, especially near the end – but they might feel chilly from time to time. In order to make progress they need the temperature to be just right.
When was the last time they had anything to eat or drink? I know hospital policies sometimes work against this, and for someone in strong, active labor eating is usually the last thing on their mind! But giving birth is an awful lot like running a marathon. We’d never expect anyone to complete that endeavor without food and drink to fuel them. Making sure they are well nourished and well hydrated throughout the labor process goes a very long way toward making good progress.
When was the last time they changed position? Babies really do need close to continuous movement throughout labor so they can make all the twists and turns necessary to be born. Gravity always helps in this process – the baby must come down before they can come out. Encouraging a laboring person who hasn’t changed position in the last 30 minutes or so might be just the nudge that the baby needs to move into a more favorable position for labor progress to continue.
Have they gotten into the shower or tub? Hydrotherapy – a fancy word for using water during labor – has a calming and relaxing effect. And closing the door to the bathroom affords more privacy which allows them to let go even more and move deeper into labor.
But after addressing all of these physical needs – it’s vital that we check in with the laboring person about their emotional needs. In fact, this might be the real reason why they’re stuck.
Did they have a fight with their partner the night before labor began? Did it ever get resolved? A laboring person might be thinking: “How can I bring my baby into this disconnected family?” This might seem overblown. But these emotions don’t have to be “rational” to have an impact on a person’s labor progress.
Who’s in the birthing room? Are they helping or hurting their progress? I’ve been at a birth where there were eight people in the room when the baby was born. The laboring woman spoke of how amazing it was to feel like everyone was pushing with her to bring her baby into this world. But I’ve also been at a birth where one wrong person in the room has shut the whole labor down. The laboring woman was unable to make any progress until the person was asked to leave.
What kind of anxieties do they have about the baby’s health? Or concerns they might have about becoming a parent? This mental anguish can be so powerful that it can bring their labor to a screeching halt.
I know a couple who’d been married for almost 10 years when they finally decided to have a baby. Her home birth was carefully planned out and she had an excellent birth team assembled. But after 3 days of contractions – she still wasn’t in active labor. Her midwives thought some privacy would be helpful and asked everyone to leave the couple alone. What happened next was astounding! The woman looked at her husband, announced “I don’t think I’m going to be a very good mother!” and started sobbing. Her husband reassured her, saying she was already a good mother, he acknowledged that he was scared too, and that they would take this parenting thing on together. It was all going to be okay. She had a baby in her arms about six hours later!
If we spent as much time checking in with pregnant people about their emotional well being as we do their physical well being in the weeks and months prior to giving birth, they might be able to clear their emotional landscape and prevent getting “stuck” in the first place. If we check in with their emotional needs during the actual labor, create an atmosphere that is physically conducive to giving birth and stop using that awful phrase “failure to progress” – we might be able to get them unstuck in the moment.
Every laboring person deserves the right physical and emotional space to express their needs so they can progress in their labor. They should never have to feel stuck.
Did you ever get stuck while giving birth? What helped you to get unstuck?