Prolonged Labor and Cerebral Palsy

Fact Checked

Prolonged labor and cerebral palsy often occur together because of the complications that arise. Labor that lasts for 18 to 24 hours or more increases the risk of cerebral palsy developing in the baby. It is a significant risk factor for this condition.

Does Prolonged Labor Cause Cerebral Palsy?

The primary cause of cerebral palsy is brain damage resulting from oxygen loss to the fetus or brain malformation. Prolonged labor does not directly cause cerebral palsy, but it can lead to complications that increase the risk.

What Is Prolonged Labor?

Prolonged labor is also referred to as “failure to progress.” It refers to labor that continues for about 18 to 24 hours after regular contractions begin. For twins, labor that goes on for 16 hours is considered prolonged.

Mothers having their first baby are expected to be in labor for a longer period of time, so prolonged labor may not be declared until 22 to 24 hours. In contrast, for second or third-time mothers, labor may be considered prolonged after 16 to 18 hours.

What Causes Prolonged Labor?

There are many potential causes of prolonged labor. A very large baby may cause labor to take longer because it cannot move through the birth canal.

Malpresentation of the baby can also cause prolonged labor. This means the baby is in an unusual position.[1]

Other possible causes are an abnormally small pelvis or birth canal in the mother, weak uterine contractions, a slow-effacing cervix, or even severe anxiety or stress in the mother.

Treating Prolonged Labor

If labor takes an unusually long time, a woman’s doctor or nurses will monitor her carefully for the timing of contractions and their strength. They will also monitor the fetal heart rate and the mother’s vital signs.

If the prolonged labor continues, contractions seem too weak, or the health of the mother or baby is at risk, doctors may take steps to speed delivery:

• If the baby is already in the birth canal but delivery is still taking a long time, a doctor may use instruments like forceps or a vacuum extractor to help pull the baby out.
• If the baby has not progressed that far, the mother may need to take a medication called Pitocin to speed up and strengthen contractions.
• This can help delivery progress better, but if it does not help enough or if the risks to the mother’s or baby’s health are deemed significant, the doctor may perform a Cesarean section.

Prolonged Labor Puts Women and Babies at Risk

Prolonged labor during the second stage—after the cervix has dilated to ten centimeters—poses serious risks for the mother and her baby.

Mothers experiencing prolonged labor are more likely to have postpartum hemorrhage, obstetric trauma, infections, or a combination of health problems.

Babies born after a prolonged second stage of labor were found to be at a greater risk for a combination of health issues, for being admitted to the neonatal intensive care unit, and for having a low score on the 5-minute Apgar test.[2]

The Apgar test is evaluated one minute and five minutes after birth to determine how well the baby is faring. It looks at heart rate, muscle tone, reflexes, breathing, and skin color.

Low scores are associated with difficulty breathing, a low or absent heart rate, low muscle tone, poor or no reflexes, and blue skin color. A low score has also been associated with later diagnoses of cerebral palsy.[3]

How Does Prolonged Labor Cause Cerebral Palsy?

Results from studies are clear: prolonged labor puts children at risk for developing cerebral palsy. Exactly why this is true is not completely understood or may not be known in every case, but there are several likely possibilities.

If labor is prolonged but the baby is already in the birth canal, the doctor may use instruments to pull the baby out.

The use of forceps or a vacuum extractor can cause damage to a baby’s skull, literally by crushing it with too much force. This can easily lead to brain damage that causes cerebral palsy.

Another cause of brain damage leading to cerebral palsy is oxygen deprivation in the fetus or newborn, known as birth asphyxia. The longer the baby is deprived of oxygen, the more severe the damage may be.

Things that can cause birth asphyxia are also associated with prolonged labor:

• Hemorrhaging
• A large baby that gets stuck in the mother’s pelvis
• Complications with the umbilical cord
• Shock in the mother
• Tearing of the placenta from the uterus
• Abnormal presentation of the baby as it emerges from the uterus and birth canal

Prolonged labor is a problem that many women face when giving birth. It can cause several issues, but with the proper care from doctors and nurses, there do not have to be any lasting complications.

Early diagnosis and treatment for prolonged labor are crucial for the best outcomes. Many cases of cerebral palsy could have been avoided with better medical care.[4]

If you had prolonged labor and your child was diagnosed with cerebral palsy, you may be able to file a lawsuit to prove that your medical care was inadequate and seek the justice and compensation your child needs to live with this condition.