After a mom has reached the definition of “active labor” which includes that her cervix is over 4 cm (although many women can walk around for weeks at or over 4 cm dilation), if she ever goes longer than 2 hours without cervical change, she is likely to be diagnosed with “stalled labor” and wheeled off for a C-section. Apparently doctors think it is impossible for a woman to have a plateau in dilation and then start again, although many if not most midwives will recognize that this is a “variation of normal” and as long as everything is going along well with mother and baby (specifically, unless the mother requests a C-section, or the baby’s heartrate becomes “non-reassuring”, or something along those lines), midwives are content to wait.
If you haven’t seen it yet, you really need to watch this video clip, in which a doctor discusses a study they undertook at his hospital which looked at whether stalled or arrested labor is really an indication for C-section, in the absence of other factors. The short version is that as long as the baby was tolerating the labor, there was no need to rush — many moms in the “stalled labor” group went on to progress to full dilation and have a vaginal birth, sparing themselves and their babies from a C-section and recovery. Not only did moms as a group did better with vaginal birth than Cesarean (no surprise there!), but the vaginally-born babies were not harmed by their “extended stay” in utero. Actually, since the World Health Organization’s “Safe Motherhood” guidelines say that for normal, healthy women without complications, vaginal exams should be limited to every four hours, getting checked every hour or even every two hours may just be too much. I wonder how many moms have been told that they had stalled labor because they were checked every hour, when if they had had four hours between checks would have had more dilation. But too many women aren’t being given four hours — they’re being told that a plateau in dilation equals a Cesarean, and they believe what they are told.
This reminds me of what my Bradley instructor said probably every class, if not several times during class: “Is mom okay? Is baby okay? Then why can’t we wait?” Apparently, we can!
Oh, and for what it’s worth, my sister had a “stalled labor” in her second birth — she was at 6 cm dilation for 9 hours — and went on to have a normal vaginal birth (only pushed 5 minutes, too… but then, her longest pushing phase was 20 minutes), so stuff like this happens. And considering the benefits of vaginal birth over Cesarean for both mom and baby, as long as mom and baby are tolerating labor fine, why the rush?