DOULA+INFLUENCER+ADVOCATE

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Failure To Progress

Heard this before?  That dreaded big stamp we put on a woman’s forehead saying “failure to progress” 😕  Its one of the leading diagnosis resulting in a cesarean birth.   First time mothers, who tend to have longer labors, are most susceptible to being diagnosed with “failure to progress” and wheeled off to the operating room.   But how real and common is a true arrest of labor or failure to progress?🤔   Why does it happen and what can you do?🤔



📌”failure to progress” has been overly diagnosed in the U.S. 😩 and it’s guidelines for normal progression was made in the 1950’s 😱 it’s 2019!  Your care provider should not be comparing your body and baby to a guideline that is so old and outdated!  We know so much more now📚
📌First time mothers have longer early labors, and are diagnosed more often with “failure to progress” BEFORE they even reach active labor which is 6cm😪
📌Long early labors are NORMAL.
📌It’s unfair and unrealistic to expect every mother to progress at the same rate. 

 DIFFERENT BIRTH, DIFFERENT BODY, DIFFERENT BABY!
📌Homebirths have very low transfer rates for “failure to progress” 🙌🏻
📌Truth of it is, your care provider might just have a case of FAILURE TO WAIT😑
📌It’s especially normal for the woman’s body to take a few hours break to regain energy so the Fetal Ejection Reflex can take over👶🏻💦💨
📌Remember, baby has lots of rotating and descending to do.  Give your baby ample pelvic room and time.
📌If you and baby are doing well, there’s no reason to start interventions to rush the process of birth.
📌Your cervix has lots of jobs to do, it has to thin out, move forward, come down and open😅 don’t you think patience is key?
📌Studies show that infant mortality and postpartum hemorrhage does NOT increase with longer labors, so waiting is still an option.

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The Cascade of Interventions

This chart shows how each intervention creates a consequence and casacde.


The cascade of interventions often starts with someone who is "past due date", "baby is too big", or "labor is not progressing fast enough"


None of these things are evidence based care and leads to unneccesary inductions that can lead to poor outcomes for mother and baby.


When everything fails, baby is in distress and an emergency C-Section is needed, the mother will be labeled as "failure to progress", and the provider will be praised for saving the baby that he/she put in danger.  When in reaity it was FAILURE TO WAIT!


It's important to remember that every action has a consequence and that the benefits must outweight the risks.



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 🚺REASONS WHY YOUR BODY AND BABY MAY NEED MORE TIME:
➖Your body may be taking little or long breaks that are normal, especially right before Fetal Ejection Reflex starts
➖Your baby may be in an unfavorable position. squats, hands and knees, wide open pelvis will help allow your baby the room to turn(if you have an epidural in place, request a peanut ball between your legs or a bunch of pillows to open pelvis, and turn from side to side every 15 minutes)
➖Talk about things.  Is there something happening emotionally?  Talk about any fears or concerns you may have.  Women who have experienced abuse can hold onto trauma during birth and in turn will hold their babies in subconsciously.
➖Inductions and epidurals are known for causing “failure to progress”.  Your body and baby may have not been ready to birth.
➖If on pitocin due to an induction, ask for a break from pitocin.  Shutting it off for some time may allow your body to regenerate its sensitivity to pitocin.  Your body builds tolerance to it, it can be useful to take a break and start again.
➖You’re in early labor!  Take this time to rest in between contractions, close your eyes, relax as much as possible, eat and drink to gain strength😴🥣🥛💪🏻stay in the comforts of your home during early labor.
➖There’s too much going on in the room.  Lower your adrenaline levels by turning the lights low, use soft voices, request that extra persons leave the room, request massages, play soothing music, use essential oils, cuddle with someone you love
➖if pushing phase is lasting long(common with epidurals), ask to wait longer to labor down.   Just because you’re 10cm doesn’t mean you should push right away.  Wait for baby to get nice and low before pushing.  USE GRAVITY!  You can still get into a vertical position with an epidural.  GET OFF YOUR BACK IF YOU WANT TO!
➖You’re a first time mommy and you just need more time.
➖Your body and baby just want to do things at its own pace

➖You have every righ to stop the induction and go home to wait for labor to progress on it's own.



 

✅THE WORLD HEALTH ORGANIZATION SAYS:
“EVERY BIRTH IS UNIQUE, SOME LABOURS PROGRESS QUICKLY, OTHERS DON’T. UNNECESSARY MEDICAL INTERVENTIONS SHOULD BE AVOIDED IF THE WOMAN AND HER BABY ARE IN GOOD CONDITION......LABOUR PROGRESSION AT 1CM/HR DURING THE ACTIVE FIRST STAGE MAY BE UNREALISTIC FOR SOME.  THIS THRESHOLD SHOULD NOT BE USED AS A TRIGGER FOR MEDICAL INTERVENTIONS”✅


✅ACOG URGES CARE PROVIDERS TO ALLOW LONGER LABOURS AND PUSHING PHASES TO REDUCE CESAREAN RATES AND HAVE CHANGED ACTIVE LABOR MARKER FROM 4CM TO 6CM✅


🙌🏻💪🏻YOUR CARE PROVIDERS FAILURE TO WAIT SHOULD NOT BE INTERPRETED AS “FAILURE TO PROGRESS”💪🏻🙌🏻

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