So I had a lady I was taking care of that had her contractions pretty much stop at 8cm. She was doing it natural, with no other meds give, membranes were not ruptured, she just stopped laboring. The doc and other nurse that took over her care where thinking it was CPD, but I figured that something else had to be going on. If it's truely CPD, labor does not just stop, it keeps going, you just don't dilate...so....I thought I'd ask you guys out there if you had ever heard of a labor just stopping at this point, and what you do about it.

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There's something called the Natural Alignment Plateau.

It's a normal period that occurs in over 50% of natural births. It is a part of first stage labor that some women experience and some women do not.

There are many ways to evaluate the progress of labor, which include: dilation, effacement, station, strength of contractions, time between contractions, duration of contraction, behavior changes, loss of modesty, emotional signs, etc. None of these methods of evaluation are completely reliable on their own, but if they are used together, the coach can get some idea of where they are in labor.

Medical personnel deal mostly with dilation, effacement, and station. They also deal mostly with medicated mothers. They are used to managing labors rather than allowing them to follow their natural course. They like to see a regular pattern of progress in regards to dilation. But it is not uncommon for a mother to reach a point where labor continues, but dilation of the cervix stops for a time.

During this time there are many things that may be happening that are necessary for the birth process to take place. Some of these things include:
1.Physical alignment of the baby’s presenting part in relation to the mother’s pelvis. This is something we cannot determine; the baby must find the best way through this narrow passage.
2.Softening of the cartilage in the pelvis and increasing flexibility of the ligaments and tendons as the mother’s body prepares to accommodate the baby.
3.Time for breasts to form all the immunities necessary to protect the baby after birth. Secretion from the breasts prior to the onset of labor are very low in these immunities, yet they are full of them by the time the baby is born- this may require some extra time.
4.The baby may be in need of more contractions which massage the baby, stimulate its nervous and prepare it’s lungs for breathing on the outside.
5.Psychological changes in the mother: Adjust to taking on responsibility of another life; anxiety at baby’s first step toward independence; environment where they feel safe and secure.
6.Psychological changes in baby. (Evidence tends to support that the baby may be going through psychological and emotional changes during this time.)

During this time, it can be very easy for a mom to become discouraged by statements that she may hear. “You’re still 5. You’re only 5 cm. You’re not getting anywhere. You’ve failed to progress.” These mothers are working very hard in this time and they are progressing, they just aren’t dilating. They may continue for many hours this way, or only for a short time, each according to her own needs.

It is very important to for the coach to keep the mother from getting discouraged at this point. Remind her that she is progressing- she’s just not dilating. This is very important work that she is doing. It may be a good idea to put off vaginal exams for a while and explain to the medical team that as long as mom and baby are doing fine, you are willing to allow them the time they need.


This plateau can be just the time that mom needs to get ready and prepared for pushing!
Do you have any research to back this up? It makes sense to me, but I know I would have a hard time convincing my fellow medical personnel:)
no. sorry. no research on hand to go along with it.
I remember reading about this. I think it was in the archives on www.gentlebirth.com. Not positive but think thats where I saw it.
the bradley method also teaches about it.

as well as Hypnobabies. they briefly touch on it.
I guess I'm wondering too, how do you distinguish between this and a labor that is really in trouble? ie baby really is too big, or head is positioned wrong, or uterus is exhausted.
During my research into undrugged births I remember coming across some literature discussing the transition phase, and the fact that labor can significantly slow or stop for up to a few hours with no negative effects. The author seemed to think that this is nature's way of giving the mom a break before the expulsion stage. I was hoping for a break during transition myself, but didn't get one.
With my daughter's first pregnancy, she stalled at 6 cm dilatation. She had been in labor for 24 hours at home and the decision was made to go to the hospital. Despite all the fluids that we encouraged at home, she was dehydrated. In the hospital an IV was started. She assumed a left side-lying position because the baby's fetal heart rate pattern was best in this position. Over the next 5 hours she slowly dilated to 9 cm. We waited patiently over the next hour or more for the anterior lip to go away. Suddenly the baby rotated slightly, moved down in the pelvis and pushing was less than a half hour. The baby was healthy--with a larger head circumference than average. We just had to wait it out.

During my experience as a nurse I have noticed that a when a woman is dehydrated the contractions become ineffective. In my daughter's case it was dehydration and also the need for the baby to align his head just right to descend.
After 16 years of practice as a doula, I've learned that dilitation doesn't mean that much. I know it's a big medical factor in determining labour, and the belief is that the absence of dilitation after a certain period can indicate a stall, but I don't believe it in most cases, providing Mom and baby are well. I recently had a lady who seemed to just be entering active labour, and we arrived at the hospital to find her cervix was 9cm. She stayed that way for the next 18 hours or so, even though her contractions grew in intensity like a regular labour. There was some stalling again at 10cm, but the baby was born vaginally. I recently had someone at 5 cm and contracting for around 3 days with little change in the cervix. vaginal birth. I think we need to believe that some changes in labour are subtle, that important work is going on, even if it can't be tangibly assessed by numbers. I also don't believe frequency of contractions is the be all and end of all "diagnosing" labour. I've seen women have 2 minute apart contractions, and then as more active labour comes on, the contractions get way farther apart, but stronger, and result in birth. It's a mystery.
The issue I had with this lady, though, was that her contractions were getting less and less intense. At 8 cm. she was not even working through her contractions...this is what had me worried that perhaps her uterus was just tired. I guess I am wondering if this might just be nature's way of taking a break or if this is something which should really concern me.
If I was working with this lady I would encourage her to drink broth, raspberry leaf tea--something that provides fluid and electrolytes. In the hospital, an IV of Lactated Ringers supplies the electrolytes. In the hospital situation I speed up the IV fluid to see if it helps. Often it does.
The uterus needs an available balance of calcium, magnesium, potassium to continue the work of contracting. Sometimes a woman is depleted and needs a boost. Another alternative is gatorade.
The down side of gatorade is the high sugar content.
I used "Smart Water" during my last birth in place of sugary sports drinks! It has akllk the electrolytes with no downside, plus it is one of the "purest tasting" bottled waters on the market, and the bottles are usually a whole liter, so you can know how much Mom has taken in.

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