Dystocia (labor stuck in the middle of the road), how to solve it?

Every prospective mother would want a normal delivery process that goes smoothly without hindrance. However, it is not impossible that labor can be stuck in the middle of the road or called dystocia (dystocia) so that you end up having to undergo a cesarean section. Immediately, let's look at the full review of the following dystocia (dystocia) congestion!

What is stuck labor (dystocia)?

Stagnant labor or it can also be called obstructed labor (dystocia) is a condition when there are obstacles during the birth process so that it takes a longer time.

As you probably know, labor occurs due to the repeated intense contractions of the labor muscles.

The contractions are usually felt right in the abdominal area and lower back. This collection of contractions then helps push the baby in the womb so that it can come out.

The contractions also help to dilate the cervix (cervix) or what is known as the birth opening.

Contraction and opening of the birth are included in the signs of childbirth which are usually accompanied by a ruptured amniotic fluid.

That way, the baby can pass smoothly through the cervix and vagina. Unfortunately, this theory does not apply to pregnant women who experience a stuck labor at the time of delivery.

In medical terms, obstructed labor is known as dystocia. The term dystocia is also commonly known as failure to progress or prolonged labor.

Labor can be described as stuck or dystocia when it lasts about 20 hours or even more.

This condition usually applies to those of you who are giving birth for the first time, as explained by the American Pregnancy Association.

Meanwhile, if you have given birth before, dystocia lasts approximately 14 hours.

Whereas normally, mothers who give birth for the first time usually take around 12-18 hours for the baby to come out.

The total time can be much shorter to 6-9 hours if you have given birth before.

Even though it looks quite dangerous, not all cases of dystocia always lead to complications of childbirth.

The condition of dystocia or dystocia in the early (latent) phase, namely at the initial cervical opening, does not necessarily cause complications.

However, dystocia (dystocia) that occurs during active childbirth can lead to complications that require immediate medical attention.

What causes obstructed labor (dystocia)?

There are various things that can be the cause of labor stuck in the middle of the road or dystocia (dystocia).

The condition or energy of the mother, the birth canal or the baby in the womb, both of which can trigger dystocia.

During the early or latent phase of labor, slow opening of the cervix (cervix) and weak uterine contractions may be the cause.

When entering the phase of active childbirth, the size of the baby's body that is too large combined with the size of the mother's small pelvis can also cause dystocia.

Mistakes when pushing and fatigue during applying the way of pushing during childbirth can make the mother experience dystocia.

In addition, other factors that can also increase the risk of congestion or dystocia are:

The mother's posture is short or less than 150 centimeters (cm).
Maternal age more than 35 years at pregnancy and childbirth.
Gestational age more than 41 weeks.
The gap between epidural induction and delivery and complete opening takes more than 6 hours.
There are abnormalities in the birth canal such as a narrow pelvis (either at the top, middle or bottom) or there is a tumor that narrows the birth canal so that it is difficult for the baby to pass.
There are abnormalities in the cervix (cervix), making it difficult to open during labor.
Are pregnant with twins, triplets, four, or more.
The influence of various psychological factors, such as stress, worry, anxiety, fear, and others.
The effect of taking pain medication which can affect the strength of the contractions.

Meanwhile, from the risk factors for the baby's condition, labor can be stuck in the middle of the road or dystocia due to the position of the baby is breech or experiencing certain abnormalities.

For example, the position of the baby's shoulder which is stuck on the floor of the mother's pelvis (shoulder dystocia) can cause obstruction of labor or labor jams.

According to the March of Dimes, shoulder dystocia is a labor complication that occurs when one or both of the baby's shoulders are caught in the mother's pelvis during childbirth.

What complications can dystocia cause?

Dystocia (dystocia) is a condition that can cause complications to both the mother and the baby in the womb if not treated properly.

The impact on the mother includes the risk of postpartum hemorrhage, trauma or birth canal injury, and infection.

Meanwhile, for babies, prolonged labor or dystocia can cause various things, such as:

Babies choke due to low oxygen levels (asphyxia in newborns).
There is a lump in the form of a collection of blood on the head (head hematoma).
The tissue on the scalp does not function or dies (scalp necrosis).
The baby's heartbeat is abnormal.
There are foreign substances in the baby's amniotic fluid.

Therefore, congestion in the middle of the road or dystocia (dystocia) is a condition that should not be underestimated.

During the labor process, doctors and other medical teams will continue to monitor the progress of your birth stages.

So, when it is found that there is a problem with both you and your baby's condition, you can immediately get medical help as soon as possible.

Help for mothers and babies who experience congestion or obstructed labor is easier to do when giving birth in a hospital.

Meanwhile, if the mother prefers to give birth at home and experiences unexpected problems, labor and treatment will continue in the hospital.

If during pregnancy the mother is accompanied by a doula, this childbirth companion can also accompany the mother during the labor process.

So, make sure that the mother has prepared various preparations for labor and supplies beforehand.

How is dystocia diagnosed?

When the normal delivery process is felt to be long enough or dystocia, usually the doctor and the medical team will perform an examination.

The following are the usual checks:

The frequency of your contractions
The force of your contractions

Dystocia examination can be done in the following ways:

Using an Intrauterine Pressure Catheter Placement (IUPC). This procedure is done by placing a device in the form of a small monitor in the uterus, to be precise next to the baby. The goal is to let the doctor know how many contractions occur, and how strong they are.
Using electronic fetal monitoring (EFM). This tool is useful for measuring the baby's heart rate.

How do you deal with stuck labor (dystocia)?

If labor obstruction (dystocia) occurs in the early stages of childbirth and there is no risk of complications, you are usually advised to do some activities.

Increasing the amount of walking, sleeping, or taking a warm shower are things that are usually recommended.

You can also change and find the most comfortable position when sitting and lying down.

Meanwhile, for cases of dystocia caused by baby shoulder dystocia, doctors must take several ways to remove the baby.

Most cases of babies who develop shoulder dystocia at birth can be delivered safely.

It's just that complications of shoulder dystocia can run the risk of causing problems for both the mother and the baby.

Shoulder dystocia is a complication of labor that is difficult to predict and prevent.

Some of the ways doctors usually treat shoulder dystocia are as follows:

Put pressure on the mother's stomach.
Ask the mother to bend her legs and bring her knees closer to her chest.
Helps rotate baby's shoulders manually.
Perform an episiotomy to make room for the shoulder.

These methods sometimes risk causing nerve injury to the baby's shoulders, arms and hands.

But usually, it will gradually improve within 6-12 months.

In addition, doctors and the medical team can also do the following things to help overcome labor jams:

1. Using forceps

Forceps are a device that helps pull the baby out of the vagina.

This device is usually used when the baby's head is in the middle of the birth canal and complete opening, but is obstructed and difficult to get out.

In addition, forceps can also be a doctor's choice to assist in a good birth if the mother feels tired to push.

2. Provide pitocin

If the strength of the contractions during labor is not great, the doctor can give you the drug pitocin (oxytocin).

This pitocin drug is tasked with speeding up and increasing the strength of contractions.

3. Caesarean section

After being given the drug pitocin, usually the strength of the contractions will gradually increase.

However, if later the labor is still stuck (dystocia), the doctor will usually take the step through a cesarean delivery operation.

The method of giving birth by caesarean section is also needed if the dystocia is caused by the size of the baby's head that is too large, or the mother's pelvis is too small.

In other cases such as breech baby position, abnormalities in the birth canal, or abnormalities in the cervix (cervix), caesarean section can be performed.

In most cases, caesarean section is the main and safe way to deal with obstructed labor, while avoiding further complications.