If it does not go any further: birth arrest
What to do if it does not continue?
A birth arrest occurs when the birth does not progress for several hours. There is no clear definition defining the exact duration of the shutdown. The diagnosis is largely at the discretion of the treating physician. Whether a birth is present, also depends on the circumstances.
An important factor is whether the woman has already given birth to children. In addition, it must be considered whether the patient has received epidural anesthesia (PDA). Basically, a birth-loss is assumed if no progress can be detected in a first-time mother without a PDA in the expulsion phase after two hours.
With PDA, the upper time limit is three hours. For a woman who has already given birth to a child, the upper limit without PDA is two hours or one hour without PDA. The health of the mother and the child also play a role. As long as the health of both is good, a temporary birth can be waited quite. As an approximate guideline, the birth of a first-time mother should not last longer than 24 hours.
Causes of birth arrest
A birth arrest can have different causes. A distinction is made between a standstill during the opening phase or during the ejection phase. At a standstill during the opening phase, the cervix does not open further. Possible causes are weak labor and too much fetal head for the maternal pelvis.
In addition, there may be a so-called adjustment anomaly; The position of the child in the pelvis is unfavorable for the birth process. Another possible cause is cervical dystocia, a birth disorder that is typically associated with contractile weakness. A birth arrest during the expulsion phase means that the child's head can not depress even though the cervix is open.
A common cause here is the weakness of labor. In addition, this complication can occur if the child is too big. The woman giving birth may also be too exhausted to take an active role in childbirth and follow the instructions of the midwife. A PDA can suppress the urge to press, causing a stoppage in the Austreibungsphase. Psychological causes such as anxiety can also be the basis.
How can a birth be seen?
The main symptom of this birth complication is the lack of progress at birth. If the birth takes a long time, the uterine muscles are weakened and overstretched. The period of time without progress is exactly a standstill, is not fixed and will be decided in each case.
Basically, the birth does not begin until the contractions are strong and regular enough to open the cervix. It is not uncommon for a birth to lead to a significant lengthening of the birth, which exhausted women are exhausted after a few hours. In this situation, they are sometimes no longer able to actively help with the birth. In general, however, this complication is not dangerous as long as the mother and child are well.
When will the birth be "canceled"?
Diagnosis often proves difficult because every birth is unique. Even with longer periods without progress, there is not automatically a birth loss that needs to be treated. If the mother still has enough strength and the child is not in danger, nothing further speaks against a spontaneous birth. Doctors diagnose a stoppage usually after two to four hours without opening the cervix or migration of the child into the pelvis.
What to do if it does not continue?
The treatment depends on the needs of the mother and the cause of birth arrest. If the woman is anxious and cramped, in many cases a relaxing bath helps. In addition, a change in the position of the baby or a change of sides can spur birth every few minutes.
Movement during childbirth is important because it allows the head to properly adjust to the birth canal. If the birth staggers, a short walk with companions is recommended, as it increases the labor activity. Wehenmittel are used when all measures to promote labor are unsuccessful.
Even before birth, it may be worthwhile to visit a specialized physiotherapist to dissolve any muscle tension in the pelvis. Such blockages are often the cause of a stoppage at birth. In addition, a birth preparation course is important to learn relaxation techniques.
Caesarean section is required if no action is effective and the health of the child or mother is at risk. If the child has already slid far into the pelvis, a Caesarean section should only be considered in an emergency. In such cases, delivery using a suction cup or forceps is associated with fewer complications.
Cesarean section as a last resort
Frequently, a birth arrest can not be prevented. An ultrasound scan can diagnose a mismatch between the size of the maternal pelvis and the size of the fetus. If the mismatch is very large, no natural birth can take place. An ultrasound examination can also detect a malposition of the child.
If the child no longer rots before birth, a caesarian section is usually necessary. A healthy diet and adequate exercise are especially important during pregnancy. Birth is less likely to occur if the woman regularly practices exercise during pregnancy.