Abnormal Labour: A Guide for All Moms to Be

Welcoming a new life into the world is both exciting and overwhelming. As an expectant mother, it’s completely normal to have questions and concerns about childbirth—especially when terms like “abnormal labour” come up.

The thought of something not going as planned can feel daunting, but you should know that every labour experience is unique and that you are not alone. Many mothers face unexpected challenges during labour, but these situations can be managed with the right support and knowledge.

Let’s walk through what abnormal labour means, why it happens, and how you can confidently navigate it.

In most cases, labour follows a predictable pattern. Normal labour involves the gradual dilation of the cervix (up to 10 cm) and consistent contractions, helping the baby move through the birth canal. This process usually occurs smoothly over hours. The average duration for a first-time mother is 12 to 18 hours, while subsequent births tend to be shorter. While normal labour is expected, sometimes the body needs extra assistance, and that’s when abnormal labour may occur.
For many, labour is a long but normal progression. However, if something deviates from this, it might be classified as "abnormal labour". The good news? Even in such cases, treatments and interventions ensure both you and your baby stay safe. 

Abnormal labour, also called "labour dystocia", happens when the progress of labour stalls or fails to proceed as expected. This can occur during any stage of labour and might involve issues like a slow dilation of the cervix or difficulties with the baby’s descent into the birth canal.

It's important to understand that abnormal labour doesn’t necessarily indicate something is seriously wrong—it simply means that labour isn’t following the usual pattern.

It’s more common than you may realise, and many mothers encounter it during their birthing journey. Studies by the World Health Organization (WHO) show that 10-20% of women experience labour dystocia globally, and the prevalence in India aligns with these numbers due to similar birth trends.

Rest assured, with proper medical care, most cases are managed effectively, ensuring the well-being of both mother and baby.

Types of Abnormal Labour

When labour doesn't follow the expected course, it can take different forms, depending on how it progresses. Understanding some of the most common abnormal delivery types can help you feel more prepared and less anxious if this situation arises.

Each type comes with its challenges, but with the right medical guidance, these can be managed to ensure the safety of both mother and baby. Here are some common types of abnormal labour:

1. Prolonged Labour: Labour that lasts more than 20 hours for first-time mothers or more than 14 hours for those who have given birth before.
2. Arrest of Dilation: This happens when the cervix stops dilating before it reaches full dilation, typically at around 6 cm.
3. Arrest of Descent: Once the cervix is fully dilated, the baby may not descend through the birth canal as expected.
4. Uterine Inertia: The uterus may become weak and unable to sustain strong, consistent contractions, slowing the entire labour process.

Each of these situations may require different interventions, from medications to assist with contractions to possible caesarean delivery. 

Labour dystocia, or slow and difficult labour, can be caused by various factors, many of which are beyond the mother’s control. Common causes include: 

• Maternal exhaustion: Labour can be physically exhausting, and after many hours of contractions, a mother may become too tired to push properly.
• Inadequate contractions: When the uterine muscles are not contracting strongly or regularly enough, it can slow the baby's movement down the birth canal.
• Baby’s position: If the baby is in a less favourable position, such as facing upwards (occiput posterior), labour may progress more slowly, making it harder for the baby to descend.
• Labour dystocia: This condition, characterised by slow or difficult labour, is a common cause of abnormal delivery, but rest assured, your doctors are fully equipped and experienced in managing it to ensure a safe and smooth delivery.

According to the National Institute of Health and Family Welfare (NIHFW), abnormal labour is one of the primary reasons for caesarean sections in India, accounting for over 30% of cases in urban areas.

Maternal Factors Contributing to Abnormal Delivery

Several maternal factors can influence labour progress, potentially leading to an abnormal delivery. These factors are often beyond the mother’s control and can affect the body’s ability to move smoothly through the stages of labour. Understanding these contributors can help expectant mothers feel more informed and prepared.

Foetal Factors Leading to Dysfunctional Labour

In some cases, factors related to the baby’s size, position, or condition can lead to a slower or more difficult labour, known as dysfunctional labour. These foetal factors are typically detected during prenatal care and can impact how labour progresses. Knowing these possible challenges helps parents feel more prepared for what to expect.

Abnormal labour can lead to complications, but understanding them helps you stay informed and prepared. Prolonged labour, for example, can increase the risk of maternal exhaustion, infections, or the need for medical interventions like assisted delivery or a caesarean section.

Foetal distress, where the baby experiences reduced oxygen levels, may also occur, requiring emergency interventions. Although complications can arise for both mother and baby, the right medical care can manage these risks effectively for the best possible outcome.

Doctors will closely monitor you and your baby to address any issues that may arise during labour.

Maternal Complications

Maternal complications from abnormal labour can include an increased risk of uterine infections, which may develop due to prolonged labour. Additionally, the strain of prolonged labour can lead to pelvic floor damage or uterine rupture in rare cases.

Women may also experience extended recovery periods after delivery, especially if interventions like forceps or a caesarean section are needed. Proper medical care ensures these complications are minimised and managed effectively.

Foetal complications during abnormal labour can involve oxygen deprivation (hypoxia), which may impact the baby’s heart rate and development if not addressed quickly. Birth injuries can also occur, especially in cases where assisted delivery methods are required. In some instances, low Apgar scores—a measure of a newborn’s physical condition—may indicate immediate care is needed. However, vigilant monitoring can mitigate most of these risks to ensure the baby’s health.

Medical professionals will closely monitor labour progression using tools like foetal heart rate monitoring and cervical exams. If labour dystocia is detected, interventions such as oxytocin to strengthen contractions, assisted delivery methods (forceps or vacuum), or a caesarean section may be considered.

I recently spoke with my cousin Ritu, who shared her experience of prolonged labour. After nearly 24 hours, she was exhausted and unsure if she could continue. However, her doctors reassured her, and with the support of oxytocin, Ritu successfully delivered her healthy baby boy. Despite the challenges, she felt empowered by the care she received, knowing her doctors were with her every step of the way.

Indian hospitals, both private and public, adhere to strict guidelines set by organisations like the Federation of Obstetric and Gynaecological Societies of India (FOGSI), ensuring both mother and baby receive the best care.

If your contractions become irregular or suddenly stop, or you notice a decrease in your baby’s movements, you must contact your doctor immediately. Other warning signs include excessive bleeding, severe pain, or a feeling that something is wrong.

Timely medical attention can help prevent complications and ensure a safer delivery. Always trust your instincts, and don’t hesitate to seek help when anything feels unusual during labour. 

Abnormal labour may sound intimidating, but it is manageable with proper care and guidance. In India, advancements in obstetric care mean that both mothers and babies receive close monitoring throughout the birthing process. 

So, even if labour doesn't follow the expected course, there are always solutions to ensure a safe and healthy delivery. Many mothers before you have faced similar situations and successfully delivered healthy babies—take comfort in the fact that you're in safe hands.