Archive for August 3rd, 2008

I always warn the Mum’s who have laboured quickly that they could find themselves quite unpopular with their new chums from antenatal classes. It’s a double-edged sword really, if a woman has a short labour other women may consider has she ‘got off lightly’ and, as she can’t hope to rival them in the traumatic, epic nature of her labour, she may be perceived as not having worked so hard to bring her baby into the world.

A quick labour is not always that fantastic though, it may be over quickly, anything under 2 hours* is classed a precipitate labour, but it comes with it’s own problems. For a labour to be completed in such a short length of time the contractions are generally almost continuous and extremely long and intense, immediately. This makes it extremely difficult for the woman to adjust to labour and find a coping strategy. Also, it makes travel to the maternity unit extremely fraught, for both the woman and her companions. In precipitate labours it is not unusual for the birth to occur before the woman has reached the maternity unit, or even a place of safety, hence the tales of babies being born down toilets. Here is the first danger associated with a rapid birth, baby taking a tumble onto a hard surface and the cord snapping in the process. There is also, for baby, the possibility of the speed of the birth leaving it shocked and slow to respond, so requiring extra stimulation to encourage her to breath. Babies born quickly will often have red faces, close inspection shows it to be lots of tiny red ‘spots’, burst blood vessels, petechiae, with the whites of the eyes having burst blood vessels, sometimes leading to the iris’ having a small ring of blood around them.

The poor woman, having been totally overwhelmed by labour, is possibly in shock as soon as her baby enters the world. Due to baby entering the world at breakneck speed severe lacerations and tears to the vagina and perineum are likely, particularly if the birth was unattended and the woman was panicking. Even though her labour has been short she is exhausted, and frequently her uterus is as well so fails to contract efficiently which means that women who experience precipitate labours are at an increased risk of retained placenta and haemorrhage.

There are other, more severe and rare, complications, associated with precipitate labour. They are extremely rare and I’m not going to mention them here, but if you are interested one can be found here and here. A piece if research conducted in the 70’s by Erkkola and Nikkanen seems to show that precipitate labour does not result in adverse outcomes for newborns.

Precipitate labour is difficult to predict in a woman having her first baby. Obviously a premature labour is more likely to be rapid; induction of labour can lead to over-stimulation of contractions so causing labour to be precipitate, really it is something that just happens to some women and babies!

* If I book a woman with a previous labour and birth of under 4 hours I make a note of this as a ‘rapid birth’ as she is at a higher risk of precipitate labour in her current pregnancy. I also discuss with her the advisability of making her way to the maternity unit as soon as she believes that labour is starting and if she believes that the birth is imminent, phone an ambulance, make sure the door is unlocked, sit or kneel and grab a towel. If her previous birth had been trouble free, no retained placenta or excess blood loss, I suggest a homebirth.

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