What Is Failure To Progress?

[bass]

I mean I know what it means. But my question is more to obtain details on the matter. So many c sections are done because mother is labeled as "failure to progress."
What if you cervix is dilating slowly but baby is perfectly fine. I am mostly looking for facts and knowledge to avoid an UNnecessary c section for failure to progress.
Thanks for any info

 

[indigo_fairy]

This was exactly what happened to me. I went about 13hrs in hospital without dialating any further from 6cm, but the previous 12hrs I'd been at home and got to that 6. I shouldn't have let them give me syntocin (sp?) as that made my uterus contract very hard very fast and very very painfully (compared to previously), but wasn't actually dialating. Baby wasn't in distress when they told me I simply wouldn't get the baby out by myself (she was back to back), they NEEDED to get her out by caeserean so I trusted in what they said. Looking back, I would have said no and had an epidural to wait off the pain of the syntocin, and then just keep going without any further intervetion - hindsight is a wonderful thing.

This time I'm planning a homebirth and refusing syntocin to avoid any of that at all. 'Failure to progress' for me and a lot of women is basically Failure to Wait.

 

[Nikki_d72]

I'd second the "failure to wait" comment above - mainly it's not progressing at whatever set rate the Obs decide, without any deference to the fact that coming into a new and brightly-lit area, as well as new people coming and going all the time is often the cause of labour slowing up. Every intervention will increase your chances of ending with Caesearean. I was told my baby was in distress so of course signed the consent for "emergency" section. I have now got a copy of my notes and was very, very angry to read "No Fetal Distress", underlined on my notes, along with the plan to give me ONE hour to progress after the Synto was started, then advise section. It was more about the hospital's protocols than any real danger. I would advise that if you are planning to birth in hospital, or a maternity unit connected to a hospital, (or even if you're not, in case of later transfer) have a very consise birth plan drawn up and make sure you have continuity of care with you if at all possible, such as your LMC, who can enforce it for you, as you may be quite unable to voice your wishes while in labour. All the best!

 

[chuck]

1cm per hour please...I had my unnecessary EMCS because of failure to wait, they kept upping my synto, wouldn't let me eat and put me flat on my back on a monitor. My epi got broken so I ended up in a bit of distress but baby never was!!

i HATE the terms failure to progress, it is such a horrible way of putting thing immediately making you feel like a failure.

Avoid internals to start - if they dont have a number to stamp on you for how far dilated one person happens to think you are then you cant be put on a schedule according to some textbook and policy.

Stay out of hospital - BC's and HB's allow more freedom for things to happen at your own pace rather than pushing to speed things along to your detriment.

Know your rights - you are allowed to say NO to any intervention, you do not have to have drips/AROM etc but it isnt easy to say no unless you are very strong (you are at your potentially most vulnerable in labour)so make sure your birth partner understands your birth plan and will help protect your birth.

 

[bass]

thanks ladies

 

[Samantha675]

My case wasn't a failure to wait. After laboring at home for 6+ hours with multiple peak contractions I had dismayed to a 2. Transfer to hospital with epi & pit for 10 hours and only dialated a further 1 1/2 cms. My waters had broken & baby was beginning to stress. My cervix just didn't dilate, after manual attempts, drugs, and time.

I am still going to plan a homebirth this time around and plan better support and pray for single peak contractions.

 

[nervouspains]

Mine neither!
I had a c-section

Because after 4 days of having pessarys, gel, hormone drip and having my waters broken, I dilated to 4cm... 24hrs later still no further dilation.
I didnt care, all that mattered was my baby was delivard healthy and safely and that is all my concern was, not how he actually came into the world!

 

[Samantha675]

Mine neither!
I had a c-section

Because after 4 days of having pessarys, gel, hormone drip and having my waters broken, I dilated to 4cm... 24hrs later still no further dilation.
I didnt care, all that mattered was my baby was delivard healthy and safely and that is all my concern was, not how he actually came into the world!

I also think that if your body & baby are not ready there is nothing they can give you or do to make your labor progress. Even though my water broke and i went into labor naturally, I was not ready mentally and I still wonder if that contributed. I was unable to let go and allow my body to do it's thing.

 

[nightkd]

I was 'stuck' at 5cm for many many many many hours (at least 12 hours :O)... It was because I didn't get enough sleep, so my body didn't have the energy to get past that point. I ended up in hospital with an epidural, simply to be able to sleep and as soon as I'd rested some, I progressed to 8cm!

As soon as the hospital staff discovered how long I'd been in labour (almost 30 hours by that point) they started mentioning c-section, but my homebirth MW was there to back me up and they soon piped down. DD was totally fine, her heartrate stayed at regular, healthy levels, even during contractions and she was crowning for 3 hours!! As long as the baby isn't showing signs of distress and both mama and baby seem healthy, there is no reason to rush a c-section, simply because mama's body needs time to rest before continuing to progress in order to deliver baby.

Your body knows what it's doing and if you stop progressing, it is likely because your body is taking a rest before getting on with the job!

Of course there are situations where c-section is necessary... But if everyone is healthy, then it's best to wait and see.

 

[Nikki_d72]

Mine neither!
I had a c-section

Because after 4 days of having pessarys, gel, hormone drip and having my waters broken, I dilated to 4cm... 24hrs later still no further dilation.
I didnt care, all that mattered was my baby was delivard healthy and safely and that is all my concern was, not how he actually came into the world!

I also think that if your body & baby are not ready there is nothing they can give you or do to make your labor progress. Even though my water broke and i went into labor naturally, I was not ready mentally and I still wonder if that contributed. I was unable to let go and allow my body to do it's thing.

Which is why induction carries a much higher rate of C-section for 'Failure To Progress' - If a woman's body isn't ready, or the baby isn't ready, they are wasting their time and only creating distress and the inevitable surgery by inducing. Fair enough if it is for genuine medical reasons, but simply for "post dates" is not a medical reason, so long as mother and baby are well. Syntheitc Oxytocin has been shown to stop the brain producing it's natural Oxytocin and also reduce the uterus's sesitivity to it, thus requiring more of the stuff to produce contractions, which can then lead to hypersensitivity, it becomes a vicious circle. IMHO, inductions need to be carefully considered, not done in a routine manner, and dosages better managed when they are carried out.

 

[Bournefree]

Couldn't agree more with the whole failure to wait! Women are put under such unearthly pressure to get baby here because of policy and it isn't conducive to labour at all. Then to top it off labelled with the word failure.. It's just horrible.

The only genuine reason babies don't come out vaginally and there is a failure to progress is when there is cephalic - pelvic disproportion (i.e baby too big to descend through the pelvis), the true incidence of this is tiny..! Women are made to feel their is something wrong with them, and they are not doing something right, at a time when they are most vulnerable and need time, calm and support. We don't even treat animals bred in captivity with such little respect - we let them get on with.
Xxx

 

[My_First]

I was 1cm dialated for three days and was in early labour (had an hormone drip for the last day) and still didnt progress beyond the 1cm. Only option was a c-section. Leos head was stuck in my pelvis, he would never had got out naturally. After being awake for three days and not eaten, I dont think I woudl have had the energy to have him vaginally.

I was labelled an FTP - they didnt have a HTB (Head too big) option

 

[chuck]

When i was asked by MW's about my pervious labour I wouls always say slow progress rather than failure to progress.

I did dilate....just very slowly by their 'rules'

 

[moodle]

As a wise woman once told me... is it Failure to Progress or FAILURE TO BE PATIENT?

The whole 1cm per hour thing started in a busy maternity hospital in Dublin during the last century, it was purely a way to manage lots of women.

Our bodies are unique, wonderful and magnificent. They don't usually match up to neat measurements and ideas, that's what makes them so great.

 

[kmac625]

My case was slightly different but ended with a similar result, emcs. I was induced at 13 days overdue with pitocin. I didn't need the gel because I was already 3cm and 90% effaced. I ended out with hyperstimulation of my uterus and the pitocin was turned off in the middle of the night. In the morning they turned it back on and I got to 10cm easily, but Clara never dropped into my pelvis. They even got me to try pushing for 45 minutes to see if that would get her to drop, but no luck. 17 hours after they started the initial pitocin drip Clara was born by c-section. Not exactly failure to progress, but I don't know what else to call it in that situation.

 

[Nikki_d72]

Pitocin seems to raise the likelihood of having a section, some say by nearly 50%. Sounds like she just wasn't ready for whatever reason... she's gorgeous anyway and well done on the Breastfeeding, it's really hard after a section and you've still acheived it so no failure there at all!

It really is a terrible label, I just hate it.