Learn more about the risk factors, prevention, and treatment for dystocia.
What Happens in Labor Dystocia?
There is considerable variation in the diagnostic criteria for labor dystocia. Given this, labor dystocia is an umbrella term that can include a number of circumstances during delivery.
Broadly, the term refers to circumstances that result in a difficult, lengthy, or obstructed labor.
These all fall under the term dystocia:
The abnormally slow descent of the fetus during the second stage of laborAbnormally slow dilation of the cervix during active laborLodging of the shoulders of the fetus once the head has been delivered (shoulder dystocia)
Labor dystocia can occur in both the latent and active phases of the first stage of labor and during the second stage of labor.
Risk Factors
There are a number of risk factors for labor dystocia.
Number of Pregnancies
Labor dystocia is more common in those who have never had a baby before. A failure to progress in the first stage of labor resulting in a cesarean delivery or a prolonged second stage of labor mostly affects those who have not had a baby before.
Those who have had a baby before but who have not previously delivered vaginally have an increased risk of dystocia compared with others who have had a baby before and delivered vaginally.
Maternal BMI
Those with a high body mass index (BMI) have been found to have a longer first stage of labor, particularly in first pregnancies.
Studies have shown that for those who have previously been pregnant, the active phase of labor was delayed among those who were obese.
Generally, there is slower labor progression in the first stages of labor among those who are overweight.
Maternal Age
Older maternal age has been associated with labor dystocia.
Studies have found that older people who had not been pregnant before (or had not had a baby) had higher occurrences of dystocia both in the first and second stages of labor when compared with younger people.
Other Factors
There are a number of other factors that can increase the risk of labor dystocia. Being in the latent phase and having a high fetal head station (the fetus’ position in relation to the pelvis) during admission for delivery are some factors that could increase the risk of dystocia.
The prolonged latent phase of labor increases the chance of labor dystocia, as does an increasing length of pregnancy.
Prevention and Treatment
Prevention options to try to avoid labor dystocia include:
Avoiding admission during the latent stages of laborUse of cervical ripening agents for inductionAn upright or walking position in the first stage of laborContinuous use of labor support, such as a doula
Oxytocin is a treatment option for labor dystocia.
Complications
Possible complications from a prolonged labor include:
Fetal distressRisk of maternal and neonatal infectionPostpartum hemorrhageUterine ruptureIncreased risk of pelvic floor and genital trauma during deliveryIncreased risk of future pelvic organ prolapseIncreased risk of future incontinence
Summary
Labor dystocia is a term used to describe abnormally slow labor. This can be due to a variety of reasons and can occur in the first or second stages of labor.
There are a number of risk factors for labor dystocia, including first-time pregnancy, advanced maternal age, and high BMI.
Labor dystocia can result in complications both for the pregnant person and the fetus. If you have any concerns about your pregnancy or birth, you should discuss this with a healthcare provider.
