What is augmentation of labor?

Labor Augmentation: Speeding Labor Up

Pregnant Caucasian woman holding her belly in hospital
JGI/Jamie Grill/Blend Images

Once your labor and birth starts, you will most likely continue on the course of your labor. Though every now and then a labor will slow or stop. If your labor is stalled, you may require what is known as an augmentation of labor.

Question: What is augmentation of labor?

Answer: Speeding labor up, or an augmentation of labor, means that medical or natural techniques are used to help labor back on its path.

This may restart or speed your labor up.

How is Augmentation of Labor Done

There are two main ways to augment or speed up labor: the non-medical way or the medical way. Both have advantages and disadvantages, but it can be done in multiple ways including both medical and non-medical simultaneously. Here are some of the more common ways to try to speed up your labor:

Some labors are simply naturally slow and labor augmentation is not needed as a medical procedure but is done because of an emotional response to the length of labor or due to issues of space availability within the medical facility. Sometimes augmentation is done for the health of mother or baby. 

Labor Augmentation for the Health of Mom and Baby

Labor augmentation done for the health of the mother or baby may include reasons like the mother is tired and is unable to rest well in between contractions; or the mother has a fever of unknown origin and the doctor or midwife is concerned that there may be an infection and is trying to minimize the time spent in labor.

Readjusting Our Expectations of Labor

One of the issue is that we are so used to watching birth shows on television where it looks like birth happens really quickly. The truth is that there are studies that have found that labor is actually taking longer today than in previous generations. And even when we have an idea of how long labor should take, we often don't want to spend the time it takes to have the baby.

It is important that we talk about the appropriate time to go into the hospital or birth center in labor. Many women are showing up in very early labor, when they would be more comfortable at home, and are admitted prior to 4 centimeters dilation. We know that this increases the likelihood that they will have added interventions and that includes augmentation and potentially a c-section down the line for failure to progress.

Many times, trying to force labor to go more quickly can cause us to create problems that were not previously present in labor. One example might be that there is a higher risk of fetal distress when medications like Pitocin are used to help speed up labor.

Questions to Ask When Augmentation is Suggested

If your midwife or doctor is suggesting an augmentation, there are a few things to ask first:

  1. Why do you think labor is not progressing quickly enough?
  2. What reason do we have to make labor go more quickly?
  3. What options are there for augmenting my labor?
  4. Are there alternatives?
  1. What happens if we wait for a period of time?
  2. How would an augmentation change my birth plan? (Would I still be allowed out of bed? Would I require extra monitoring?)

In the end, the decision to augment should be made in an informed way between you, your partner, and your doctor or midwife. If you need more information or time before making a decision, be sure to ask.

Sources:

Kauffman E, Souter VL, Katon JG, Sitcov K. Obstet Gynecol. 2016 Mar;127(3):481-488. Cervical Dilation on Admission in Term Spontaneous Labor and Maternal and Newborn Outcomes.

Laughon, S.K., Branch, D.W., Beaver, J., Zhang, J., Changes in labor patterns over 50 years, American Journal of Obstetrics and Gynecology (2012), doi: 10.1016/j.ajog.2012.03.003.

Safe prevention of the primary cesarean delivery. Obstetric Care Consensus No. 1. American College of Obstetricians and Gynecologists. Obstet Gynecol 2014;123:693–711.

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