At a Birth arrest there is no further opening of the cervix or the child entering the mother's pelvis. Changes in position, relaxation exercises or a walk are often enough to bring the standstill to an end. If this is not enough, a contraceptive is attached or a caesarean section is performed.
What to do if it doesn't work
A Birth arrest occurs when the labor does not progress for several hours. There is no clear definition of the exact duration of the standstill. The diagnosis is largely at the discretion of the attending physician. Whether there is a birth arrest also depends on the respective circumstances.
A key factor is whether the woman has already given birth to children. In addition, it must be taken into account whether the patient has received epidural anesthesia (PDA). Basically, a birth arrest is assumed if a first-time woman without a PDA shows no progress 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 is two hours without a PDA or one hour without a PDA. The health of the mother and child also play a role. As long as both are in good health, a temporary birth arrest can be waited for. As a rough guideline, the birth of a first-time mother should not take longer than 24 hours.
Causes of birth arrest
Birth arrest can have various causes. A distinction is made between a standstill during the opening phase and during the expulsion phase. If there is a standstill during the opening phase, the cervix does not open any further. Possible causes are weak contractions and a fetal head that is too large for the maternal pelvis.
In addition, there may be a so-called attitude anomaly; the position of the child in the pelvis is unfavorable for the birth process. Another possible cause is cervical dystocia, a disorder in the course of labor that is typically associated with poor labor. A birth arrest during the expulsion phase means that the child's head cannot step down even though the cervix is open.
A common cause here is weakness in labor. Also, this complication can occur if the child is too big. The woman giving birth may also be too exhausted to take an active role during the birth and to follow the instructions of the midwife. A PDA can suppress the urge to press, which leads to a standstill in the expulsion phase. Psychological causes such as fears can also be underlying.
How does a birth arrest show?
The main symptom of this labor complication is the lack of progress in labor. If the birth takes a long time, the uterine muscles are weakened and overstretched. Exactly from which period of time without progress there is a standstill is not specified and will be decided in each individual case.
Basically, birth does not begin until the contractions are strong and regular enough to open the cervix. Not infrequently, a birth arrest leads to a considerable prolongation of the birth, whereby affected 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 safe.
When is the birth "canceled"
Diagnosis is often difficult as each birth is unique. Even with longer phases without progress, there is not automatically a birth arrest that needs to be treated. If the mother still has enough strength and if the child is not in danger, nothing speaks against a spontaneous birth. Doctors usually diagnose a standstill after two to four hours without opening the cervix or migrating the child into the pelvis.
What to do if it doesn't work
Treatment is based on the mother's needs and the cause of the birth arrest. If the woman giving birth is anxious and tense, a relaxing bath can help in many cases. In addition, changing the birthing position or changing sides every few minutes can promote the birth.
Movement during childbirth is important because it allows the head to properly adjust to the birth canal. If the birth comes to a standstill, a short walk with someone is recommended, as this increases the labor activity. Contraceptive pills are used when all measures to encourage labor are unsuccessful.
Even before the birth, it can be worthwhile to consult a specialized physiotherapist in order to relieve any muscle tension in the pelvis. Such blockages are not infrequently the cause of a stoppage in childbirth. In addition, a childbirth class is important to learn relaxation techniques.
A caesarean section is required if no action is effective and the child or mother's health is at risk. If the child has slipped far into the pelvis, a caesarean section should only be considered in an emergency. In such cases, childbirth using a suction cup or forceps is associated with fewer complications.
Caesarean section as a last resort
Often a birth arrest cannot be prevented. A sonographic examination can diagnose a mismatch between the width of the maternal pelvis and the size of the fetus. If the disproportion is very large, no natural birth can take place. An ultrasound examination can also reveal a misalignment of the child.
If the child no longer rotates before birth, a caesarean section is usually necessary. A healthy diet and sufficient exercise are particularly important during pregnancy. Birth arrest is less likely if the woman exercises regularly during pregnancy.
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