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by EBSCO Medical Review Board
(Unsatisfactory Progress of Labor)

Definition

Failure to progress (FTP) happens when labor slows and delays delivery of the baby. The cervix may not thin and open as it should. This makes it hard for the baby to move down the birth canal.

Fetal Descent Stations (Birth Presentation)
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The progress of the baby can be progressively measured.
Copyright © Nucleus Medical Media, Inc.

Causes

The cause of FTP may be linked to:

  • An unborn baby that cannot fit through the mother's pelvis
  • A baby that is not in the right position
  • Contractions that are weak or do not happen often enough

Sometimes, the cause is not known.

Risk Factors

Things that may raise the risk of this problem are:

  • Starting labor with medicine or other methods
  • Having an epidural—pain medicine placed into the spine
  • Problems with the fluid sac around the baby
  • Water that breaks before labor starts—premature rupture of membranes
  • A large baby
  • Prior FTP
  • Diabetes
  • Fertility treatments

Symptoms

Once labor has started, the baby should move down the birth canal at a certain pace. The baby's progress is either slower than this pace or it or stops.

Diagnosis

The doctor will check:

  • The width of the cervix
  • The size of the baby
  • The position of the baby

A monitor may be used to find out how the uterus is contracting. It can count how many contractions there are, how long they last, how strong they are, and how much time goes by between each one.

This is enough to make the diagnosis.

Treatment

The goal of treatment is to start labor or to speed it up. Options are:

  • Using a special tool to break the water
  • Giving the mother a medicine called oxytocin to make the uterus contract

FTP can cause stress on the mother and baby. This can lead to problems. The doctor may choose to deliver the baby by:

  • Using a vacuum or forceps to help the baby out of the birth canal
  • Cesarean section

Prevention

There are no known ways to prevent this health problem.

RESOURCES

The American College of Obstetricians and Gynecologists  https://www.acog.org 

Office on Women's Health—US Department of Health and Human Services  https://www.womenshealth.gov 

CANADIAN RESOURCES

The Society of Obstetricians and Gynaecologists of Canada  https://www.sogc.org 

Women's Health Matters—Women's College Hospital  http://www.womenshealthmatters.ca 

References

Assisted vaginal delivery (instrumental delivery). EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/assisted-vaginal-delivery-instrumental-delivery. Accessed September 13, 2021.

Labor dystocia. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/labor-dystocia. Accessed September 13, 2021.

Labor induction. The American College of Obstetrics and Gynecology website. Available at: https://www.acog.org/womens-health/faqs/labor-induction. Accessed September 13, 2021.

Protracted labor. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/gynecology-and-obstetrics/abnormalities-and-complications-of-labor-and-delivery/protracted-labor. Accessed September 13, 2021.

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