What Is Labor Dystocia?

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Labor dystocia refers to abnormally slow labor. Clinicians disagree on the characteristics of dystocia, and as such definitions vary. Other terms used for labor dystocia include difficult labor, dysfunctional labor, failure to progress, prolonged labor, cephalopelvic disproportion (CPD), and obstructed labor.

Learn more about the risk factors, prevention, and treatment for dystocia.

Birth

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What Happens in Labor Dystocia?

There is considerable variation in the diagnostic criteria for labor dystocia. Given this, labor dystocia is an umbrella term that can include a number of circumstances during delivery.

Broadly, the term refers to circumstances that result in a difficult, lengthy, or obstructed labor.

These all fall under the term dystocia:

  • The abnormally slow descent of the fetus during the second stage of labor
  • Abnormally slow dilation of the cervix during active labor
  • Lodging of the shoulders of the fetus once the head has been delivered (shoulder dystocia)

Labor dystocia can occur in both the latent and active phases of the first stage of labor and during the second stage of labor.

How Common Is Labor Dystocia?

It is difficult to determine the exact incidence of labor dystocia due to widely variable definitions. It is believed that dystocia is responsible for the majority of cesarean deliveries. Dystocia accounts for between 25% and 55% of primary cesarean deliveries.

Risk Factors

There are a number of risk factors for labor dystocia.

Number of Pregnancies

Labor dystocia is more common in those who have never had a baby before. A failure to progress in the first stage of labor resulting in a cesarean delivery or a prolonged second stage of labor mostly affects those who have not had a baby before.

Those who have had a baby before but who have not previously delivered vaginally have an increased risk of dystocia compared with others who have had a baby before and delivered vaginally.

Maternal BMI

Those with a high body mass index (BMI) have been found to have a longer first stage of labor, particularly in first pregnancies.

Studies have shown that for those who have previously been pregnant, active phase of labor was delayed among those who were obese.

Generally, there is slower labor progression in the first stages of labor among those who are overweight or obese.

Maternal Age

Older maternal age has been associated with labor dystocia.

Studies have found that older people who had not been pregnant before (or had not had a baby) had higher occurrences of dystocia both in the first and second stages of labor when compared with younger people.

Other Factors

There are a number of other factors that can increase the risk of labor dystocia. Being in the latent phase and having a high fetal head station (the fetus' position in relation to the pelvis) during admission for delivery are some factors that could increase the risk of dystocia.

The prolonged latent phase of labor increases the chance of labor dystocia, as does an increasing length of pregnancy.

Prevention and Treatment

Prevention options to try to avoid labor dystocia include:

  • Avoiding admission during the latent stages of labor
  • Use of cervical ripening agents for induction
  • An upright or walking position in the first stage of labor
  • Continuous use of labor support, such as a doula

Oxytocin is a treatment option for labor dystocia.

Complications

Possible complications from a prolonged labor include:

  • Fetal distress
  • Risk of maternal and neonatal infection
  • Postpartum hemorrhage
  • Uterine rupture
  • Increased risk of pelvic floor and genital trauma during delivery
  • Increased risk of future pelvic organ prolapse
  • Increased risk of future incontinence

Summary

Labor dystocia is a term used to describe abnormally slow labor. This can be due to a variety of reasons and can occur in the first or second stages of labor.

There are a number of risk factors for labor dystocia, including first-time pregnancy, advanced maternal age, and high BMI.

Labor dystocia can result in complications both for the pregnant person and the fetus. If you have any concerns about your pregnancy or birth, you should discuss this with your doctor.

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