"Failure to Progress": When Labour Slows Down & What To Do

Routinely, women are told that ‘failure to progress’ in labour is why they should consider a medical intervention, even though it is usually safest for them to wait and allow nature to take its course. Sometimes the course of intervention is decided upon without a mothers’ consent, which is actually illegal in most countries worldwide. Staggeringly, a study in France in 2021 showed that almost 45% of mothers (representative across the national population) received synthetic oxytocin like Pitocin to induce labour without their consent, more than 60% received an episiotomy without consent, and almost 37% were given a caesarean section without providing consent. In the UK, Birthrights.org campaigns for better awareness of birth rights, and for maternity departments to make consent their priority. 

Therefore being clear about all options possible, your personal choices in birth, including having a birth plan, and sharing your wishes with your birthing team, is critical to avoid birth trauma or regrets. 

In the context of ‘failing to progress’, this can occur in the first stages of labour (during cervical dilation) or the second stage (during active labour). The types of intervention you’ll be presented with will typically be vaginal instrumental birth using either ventouse or forceps, induction using synthetic drugs or mechanical devices, or a C-section, depending on the baby’s position in the birth canal. But in truth, there is no ‘failure’ at all, and this language does more harm than good. 

Let’s dive into why this is likely happening in so many women’s births worldwide. 

Reasons labour can stall

As a birthing person, unless your body feels safe, undisturbed, and has privacy and calm, it will be pretty much impossible for labour to unfold in a simple and straightforward way. This is because the hormone that is needed to birth freely and easily, and which creates the uterine surges that get the baby out - Oxytocin - becomes suppressed by Cortisol and Adrenaline when you feel stressed or unsafe. When your body is flooded with Adrenaline, the entire flow of labour is disturbed, which can lead to awkward positioning of the baby - for example, with its head tilted to the side instead of tucked into its chin, making it difficult to then rotate its way smoothly down the birth canal.

So if the ideal birth setting is somewhere peaceful, private and calm, where you have emotional support and can allow birth to unfold in its own time, consider instead that if you’re in hospital, you’re likely in a brightly lit room (unless you ask for the lights to be dimmed). The environment is clinical with disturbances and noise, where you feel rushed, and ‘touched out’ by doctors and midwives. A careless use of negative language by one of these caregivers could feel amplified, making you question your ability to birth and shake your confidence. Couple this with the midwife fussing around with CTG dopplers strapped to your stomach (sidenote: CTG findings are open to misinterpretation, and can often give false positive results), or carrying out vaginal examinations to check dilation of the cervix, and your nerves can become frayed even further. This unnatural environment can dramatically affect your sense of calm and feeling safe, and instead create a sense of urgency and pressure. But what happens next is that your conscious ‘analytical mind’ becomes on high alert and signals to your body that it’s not a safe place to birth, stalling the birth process. Of course, this is through no fault of your own, it’s simply the biology of what happens to us during labour, if the conditions are not supportive to our natural rhythms.

And the truth is, that this physiological response to your logical mind ‘kicking in’ is what saved women’s lives back when we were living in caves. Imagine you’re in the early stages of labour and feel surges coming on, you’ve hunkered down on all fours which is helping you to breathe through the sensations, and then out the corner of your eye, you notice a sabre tooth tiger lurking behind a coconut tree, and it looks ready to pounce - you’re gonna want to get out of there sharpish! Physiologically, what happens is that the oxygen that was feeding your uterus to enable contractions, would instead divert away to your extremities (your arms and legs) so that you could run for your life, and of course, birth wouldn’t progress. There would be a pause.

Surprisingly, not a lot has changed as the body still responds the same way when birthing, now, as it did 10,000 years ago, except that the threat is no longer the tiger but instead is any environment that subconsciously feels unsafe to birth in- including a cold and clinical ward, strip lights, stirrups and birth machinery around the room, or an unsupportive obstetrician or midwife negatively impacting your birth space. All of this ‘noise’ is going to interfere with your ability to have a conscious birth, where you can follow your baby and body’s cues, and listen to your womanly intuition. 

A hike, not a sprint

It’s important to know that labour is not a straight, predictable climb from start to finish. It’s a dance between your body, your baby, and your hormones. It’s a sacred experience that is a journey that flows, slows, pauses and resumes. And a pause doesn’t mean failure — it’s usually a sign that your body is protecting you and your baby. If both you and baby are healthy, time need not be an issue And if you choose a home birth, you’d actually be in the best place possible according to research. Studies indicate that planned home births, especially for low-risk pregnancies, are associated with much lower rates of instrumental births (like forceps or vacuum deliveries), inductions or cesarean sections. There is also increased maternal satisfaction, and definitely no one rushing you to birth by the clock. Many women report higher satisfaction with the birthing experience when choosing a home birth, citing factors like control, comfort, and a more personalised approach.

For a hospital birth, other research recommends that a mother discusses all medical interventions with her caregivers in advance of birth so that she is fully informed of each intervention’s implications, and agrees a method with her team for her to convey her consent, or not, during labour, at a time when it might be difficult for her to clearly communicate. 

Why Hospitals Sometimes Push to “Speed Things Up”

Timelines in hospital charts are often based on outdated research like the Friedman curve. The belief from this model is that the cervix should dilate 1 cm per hour - but we are not robots, and all bodies birth differently. The model is particularly controversial as it was based on data from heavily medicated, confined women in 1950s US hospitals. In contrast, modern research shows that labour is often slower and more variable, especially in first-time mothers, without being abnormal in the slightestTherefore, strict use of the Friedman curve has led to countless unnecessary interventions (inductions, forceps, caesareans) when labour was simply progressing at its own healthy pace.

Other reasons hospitals can rush things include:

• Shift changes and bed management - wanting to get the next woman on the ‘conveyor belt’ for birthing

• “Just in case” thinking to avoid later complications. Approaching birth with a fearful mindset is something obstetrics often do as they are trained to look out for problems.

• Habit — the culture of managing birth actively, rather than giving space for ‘expectant management’ which means monitoring the situation, taking observations/ blood pressure/ monitoring for signs of infection, and waiting to see how things unfold, rather than diving in with interventions.

  
  

How to ‘Buy Time’ in Hospital

If you’re told labour is ‘stalled’ but everyone’s well, here’s how to respond:

• Ask for specifics

• Breathe and have your birth partner advocate for your wishes and ask all questions, before conferring with you again:

• Propose a review point to your caregivers, saying something like: “Let us have privacy and space for the next hour, and we can reassess things again after this time”

For example, if you’re told that the baby is showing some signs of distress, before rushing into any action, another approach is to respectfully ask everyone to give you privacy, as outer circumstances may be affecting your baby’s state of ease. Having privacy will also encourage your body’s oxytocin production, as oxytocin is also known as the ‘shy’ hormone. The more you’re watched and feeling pressured to perform, the less likely you’ll be creating this hormone, and you can’t birth without it. With privacy you can create a visual orb of safety around you and your baby, which will likely help everything to calm down internally, and ultimately help labour progress

Creating the Conditions for Progress

While you’re waiting, we recommend doing some of the following, to help create a more private and birth-friendly environment:

• Lean into your birth partner for support, or go inwards and focus on steadying your breathing - both of which will get endorphins and oxytocin flowing again. Remember that you need an abundance of this love hormone for birth to go smoothly and more quickly. Having a midwife instructing you to ‘push’’ when your body doesn’t feel the need to, just adds more stress and tension and Adrenaline and then, unsurprisingly, labour will stall. 

• Dim the lights or close the curtains.

• Limit people entering the room.

• Use your body’s movement and positions to help baby rotate. For example, being on your hands-and-knees, side-lying with a peanut ball, sitting on a birthing ball to rotate your hips which is great for getting baby into the optimal position, doing lunges, or slow dancing with your birth partner.

• Use calm breathing and visualisation, or any other tools you’ve learnt through your hypnobirthing course. 

• Gently hum or sing to feel relaxed, and to relax baby

• Do anything that feels good for you, and is calming

• Eat and drink for energy (if allowed

A Gentle Reminder

You have the right to informed consent — and informed refusal.

A pause in labour is not an emergency unless there are signs of real distress. You can help ease any distress by checking in with your baby, breathing, and working together to get things back on track. Talking to your baby and remembering that you are a team, can help a great deal. But if things do not get back on track, don’t be too hard on yourself as sometimes things just won’t go the way we planned. This is where knowing your rights and choices, weighing up risk with your birth partner and following your innate intuition, is going to help guide you as to the best next steps for you, your baby and family.

Don’t fall into the trap of letting someone direct your birth - make sure you follow your body’s cues. Giving birth is an involuntary action, the same as releasing your bowels. When your baby is ready and it’s coming, you’ll know it, and no one external to you can tell you when it’s the right time to push! Only your body can :)  

Lines for you to use respectfully with your caregivers (doctor, midwife)

• “I understand you’re following the hospital’s timeline, but my body is not a clock.”

• “If baby and I are doing well, I’m happy to keep going without intervention.”

• “Let’s give it more time and recheck in two hours.”

• “We’d like a calm, private space to help things progress naturally.”

For more support, please check out our services, or book a FREE discovery call to learn more about what we offer. We are here for you, and wish you an ejoyable birth!