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Labor That Progresses Too Slowly

By Julie S. Moldenhauer, MD, Associate Professor of Clinical Obstetrics and Gynecology in Surgery, The Garbose Family Special Delivery Unit, The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia; Attending Physician, The University of Pennsylvania Perelman School of Medicine

Labor that progresses too slowly may involve slow movement of the fetus through the birth canal because the fetus is too large or is abnormally positioned, the birth canal is too small, or the uterus contracts too weakly.

Causes of labor that is progressing too slowly include the following:

  • A fetus that is too big to move through the birth canal (pelvis and vagina)

  • A fetus in an abnormal position

  • A birth canal that is too small

  • Contractions of the uterus that are too weak or not often enough to keep the fetus moving

Doctors estimate the size of the fetus and birth canal and check the fetus’s position. They also check the strength and timing of contractions. These factors determine treatment.

If the birth canal is big enough for the fetus but labor is not progressing, the woman is given oxytocin intravenously to stimulate the uterus to contract more forcefully. If oxytocin is unsuccessful, a cesarean delivery may be necessary. Or if the baby is already in position to be delivered, a vacuum extractor or forceps may be used instead. If the fetus is too big, cesarean delivery is done.