Variations of Labor

Prodromal Labor

In a prodromal labor, the early phase of labor (cervix dilates from closed to approximately three-to-four centimeters) is prolonged with contractions that do not increase in intensity. 

Prodromal labor can tire you out and use up the energy you'll need for active labor and delivery. Try alternating activities such as walking or showering with periods of rest to conserve your energy. While resting you can also drink fluids, watch a movie, or listen to music until you progress to a more active labor. Your obstetrician or midwife may suggest prescribing medication to help you sleep, which can cause the contractions to become stronger and your labor to progress. 

Back Labor

Back labor refers to labor in which much of the pain or discomfort is felt in the mother's back. Sometimes, the baby is in a posterior position (facing the mother's abdomen). 

How is Back Labor Different?

With back labor, the onset of labor may be felt completely in your back and may create some confusion about whether labor has really begun. Feeling your abdomen for "hardening or tightening" when experiencing rhythmic back discomfort may offer some indication as to whether or not this is really labor. Also, there may be residual back pain between contractions. The pushing stage may be longer due to the extra effort needed to rotate the baby to an anterior position (face towards mother's back). Some babies may not rotate and may deliver in the posterior position.

Suggestions for Dealing with Back Labor:

• Change positions frequently — Any position in which the weight of the baby is taken off your back is helpful, such as sitting, leaning forward and putting your weight on your elbows, kneeling in bed with the head of bed elevated, kneeling on your hands and knees.
• Use counter pressure — firm constant pressure applied to your lower back where the pain is localized. This can be given by your partner or nurse or by leaning against a firm object, such as a rolled towel or tennis balls.
• Heat or cold — A warm shower or bath may be helpful. A hot water bottle or an ice pack applied to your back may offer some relief.
• Sterile water injections into the skin of the lower back. Discuss this with your healthcare provider

Prolonged Labor

In a prolonged labor, the entire labor progresses at a rate that is slower than average. A prolonged labor may be due to many factors such as the size or position of the baby or having an epidural very early in labor. 

Relax as much as possible and avoid tiring yourself. Change positions frequently and use gravity-assisted positions (such as standing and squatting) during a contraction. Walking and relaxing in the shower or tub may be helpful. Every woman and her labor are unique. If your progress is slower than anticipated, try not to be discouraged. Recognize that this is the natural progression for your particular labor. Relax and allow yourself to work with each contraction one at a time. 

Precipitous Labor

A precipitous labor progresses very rapidly. Call your doctor or midwife if your contractions suddenly occur one right after the other of if the intensity of the contractions are not manageable. If birth appears imminent, call 911 and follow the dispatcher's instructions. 

Augmented Labor

Occasionally your labor may not progress even though you've had frequent contractions. If your bag of waters has not broken, your physician or midwife may attempt to augment (stimulate) your labor by breaking the bag of waters. If this isn't effective in stimulating labor, you may be given intravenous pitocin.