‘Failure to progress’ new tool to monitor labour may reduce caesarean rate

‘Failure to progress’ (dystocia) is one of the most common reasons women are given during labour for the need to resort to a caesarean despite the fact that “…no precise definition of dystocia exists.” Hospital policies or individual practise therefore tend to dictate what is acceptable in any given hospital setting. In actual fact if mum and baby are showing no signs of distress, this diagnosis should not be used as justification for a caesarean, though it often is.

This is where knowing just that little bit more about birth ‘complications’ (not that ‘failure to progress’ is a complication) and rights versus hospital policies can make all the difference to whether or not you have the birth you hope for, assuming of course you are simply progressing slower than expected.

Incredibly studies from the 1950s which suggested that cervix dilation was a linear process (dilation = 1.2cm per hour) are still being referred to as ‘normal’ progress today. New research from Ohio State University suggests not only that the progress if not linear but that they have found a way to more accurately access labour progress for first time mothers. The tool, a partographer, “is a printed graph on which a clinician can plot cervical dilation and the baby’s descent to determine whether labor is progressing normally or if intervention might be needed.”

The researchers predict that “if their partograph were adopted widely in the United States, dystocia diagnoses would be limited to only the slowest 10 percent of first-stage labors; oxytocin interventions would drop by more than 50 percent; and cesarean sections performed because of dystocia would decrease by more than 50 percent.”

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