The number one reason for first time birthing people to have a cesarean is “failure to progress.” Failure to progress is defined as a labor lasting 20 hours or more for first time parents. However, labor is not always linear and can have variations. In the 1940’s the Friedman Curve was introduced in hospitals as a means to determine how quickly a laboring person should progress in labor, approximately 1 cm per hour. Research now supports the importance of disregarding that estimation and recognizing other factors like, epidural use, fetal position, and emotional components, can prolong labor.
For those who wish to avoid an unplanned cesarean due to being labeled “failure to progress” this episode of Yoga| Birth|Babies, will resonate you. I speak with certified professional midwife (CPM), co-founder and director of Healthy Mother Sanctum Natural Birth Center, and the leading official Lamaze-certified childbirth educator, Dr. Vijaya Krishnan. Vijaya offers solid advice and tools for how to handle a slow labor, factors that can be causing an arrested labor and options to help move the labor along. Enjoy!
In this episode:
- Learn a bit about Vijaya and how she got into birth work.
- Defining a “slow labor.”
- Should pain medication be taken into account when defining a “slow labor.”
- How someone in a traditional birth setting can avoid being categorized as failure to progress.
- Melatonin and its’ relationship to oxytocin.
- Questions to ask if a person is facing failure to progress.
- Techniques to help someone with a slower labor progress.
- Reasons that may lead to a slower labor.
- How the support team can recognize if there is a physical cause like baby position compared to an emotional reason causing the slower progression.
- Possible interventions and/or collaborative care to help with a slow labor.
- Ideas for pregnant people to do ahead of time to proactively help prevent a “slow labor.”
- Where to find Dr. Vijaya’s work.
About Dr. Vijaya Krishnan:
Dr. Vijaya Krishnan is a certified professional midwife (CPM), the co-founder and director of Healthy Mother Sanctum Natural Birth Center, and the leading official Lamaze-certified childbirth educator (LCCE) in India. She is a graduate of the midwifery program from National College of Midwifery, in the US. The Sanctum Natural Birth Center is India’s only midwife-led, freestanding birth center with emergency care infrastructure built in. Vijaya has developed a unique collaborative model of care, which is midwife-led but supported by a backup medical team comprised of Ob/Gyns, when required, This unique model does not deprive so-called “high risk” moms from trying for midwife-led care, because in case of an emergency they do not need to be transported elsewhere but can be attended to safely in the same premises in the presence of their midwife. This model of care has allowed moms with GDM, PIH, breech presentation, etc., to safely experience the power of natural birth, while simultaneously benefiting from continuity of care.
As a Lamaze-certified childbirth educator, Vijaya runs the Healthy Mother Lamaze-accredited Childbirth Educator Program, which educates and certifies Lamaze educators all over India. With a doctorate in physical therapy and physical therapy education as well, she has created focused woman-centric fitness and wellness programs that cover the entire gamut of perinatal care—from the antenatal to the postnatal.
Vijaya has had articles published in Midwifery Today, Journal of Perinatal Education, and online in MIDIRS, as well. Since 2016, she has lectured widely and run workshops on gentle birth practices and respectful maternity care at universities and medical/nursing colleges in India, to sensitize the key care providers regarding wide adoption of these practices.
Currently, she is working hard as a part of Birth India, an NGO and a national advocacy group, to help shape public policy in making autonomous midwifery a recognised and independent profession in India.
Gentle Birth, Gentle Mothering with Dr. Sarah Buckley