Labor Stalls
Labor stalls can occur as a normal part of labor, such as different transitional points or an opportunity to rest, or they could result from an underlying issue.
Normal stalls could include the transition from early to active labor, active labor to transition, and transition to pushing. There may also be normal stalls during a long labor, where contractions will space out and weaken so that you can rest.
But, some stalls could result from an underlying “issue” that may resolve on its own, or we may need to add some focused effort to resolve it. These are known as the 3Ps:
- The Passenger or baby and their position
- The Passage, the path that baby is navigating through to include the pelvis and surrounding musculature
- The Power, the strength of the contractions, is usually related to you, the birther.
- Some believe there is a 4th P known as Psyche, but we believe that belongs with power since how you mentally feel can influence the strength of your contractions.
The Passage
The passage is the physical path your baby is navigating through during birth. This could include the pelvis, the pelvic floor, the uterine ligaments and uterus, the cervix, etc. Anything that the baby is moving through is a part of the passage.
A labor stall due to the passage could be due to decreased space or lack of space and may contribute to a passenger stall (baby’s position) or result from a passenger stall. Stalls are not necessarily independent of each other.
If we have a passage stall, we want to focus on movement and relaxation to create space and release tension in your baby’s path.
Signs of a Passage Stall
It can be hard to identify what exactly is causing a stall, but for a passage stall, it tends to be associated with:
- Tension during contractions or fighting contractions
- Lack of movement, either from remaining stationary during contractions or an epidural
- Inability to find certain movement patterns, such as finding internal rotation without compensation.
If you are noticing any of these signs and a slowing or pause in labor progress, then it may be a passage stall.
This course includes our 90-minute labor biomechanics webinar recording plus our 24-page labor biomechanics quick reference guide.
- 90-min webinar
- 24-Page E-Book
- Upcoming Live Webinar & Q&A
- Watch on Mobile Device
Common Passage Stall Locations
Typical times that we may notice a passage stall is usually when the baby is in the lower midpelvis (0 station and below) when internal rotation becomes the emphasis to create more space in the pelvis.
Stalls can happen at any time, but this is usually where I see more issues as a doula.
Why could this be? There is an emphasis on external rotation during pregnancy due to postural adaptions to accommodate for a shift in the center of gravity as the belly grows, an increased lumbar lordosis or curvature in the low back, and a change in how we distribute force throughout our body.
If we neglect internal rotation at the hip during pregnancy, we may find that our postural tendencies have positioned our pelvis in a way that makes it difficult to create space in the lower midpelvis without compensation.
Our 40-Week Prenatal Strength program incorporates exercises that focus on finding internal rotation as a preparation for birth!
Passage Stall Solutions
When addressing passage stalls, we want to focus on releasing tension with release exercises or labor comfort techniques and creating space with movement.
Some common things that may help resolve a passage stall:
- Labor comfort techniques that help you release and relax with contraction. This could include hydrotherapy, TENS, and counterpressure.
- Relaxation exercises such as relaxation talk throughs, breathing drills, or guided visualization
- Jiggling or massage to release tension
- Labor positions that create space in the pelvic level your baby is at, such as opening the lower midpelvis more. Positions like the side-lying release tend to be great for lower midpelvis stalls.
- If you have an epidural, rocking the leg in side-lying with a peanut ball or doing a single knee counter pressure can help to create space in the lower midpelvis.
Labor Stall: The Passage
When addressing a labor stall, understanding what may be causing the stall is a good starting point. If it seems that the passage may be the culprit, then we want to focus on creating more space, adding moving, and helping you relax and release. This could include finding laboring positions that increase the pelvic diameter at the station your baby is currently at, such as opening the lower midpelvis; jiggling the hips to help them release and let go; or trying some labor comfort techniques such as counterpressure or hydrotherapy to help you relax.
Learn more about addressing labor stalls in our childbirth education courses. We offer our courses online, completely self-paced with pre-recorded videos. Our online courses are available for immediate access and you maintain lifetime access of the course!
We also offer our courses in-person and virtually via zoom if you prefer to learn in a live setting! Our virtual and in-person courses come with complimentary access to our online course for review and reference as you prepare for your birth!