Understanding the progress of labor and the common issues that arise over the course of it are crucial for midwives since it helps create a supporting and safe environment for women. The primary focus throughout labor should be on the woman, her emotional and physical comfort. This paper aims to review the common aspects of labor, such as progress, premature urge to push, and emotional dystocia.
Friedman’s work described the labor progress as follows – the first stage of labor or the active stage can last from five to eight hours. Next, there is the second stage or the pushing stage (Gabbe et al., 2016). Augmentation of labor can be suggested if the process is not progressing normally, for example, if the labor is prolonged and the cervix is dilated at less than 0.2 inches. According to King, Brucker, Osborne, and Jevitt (2018), augmentation is suggested once a woman enters an active phase, and the progress is slower when compared to the general population. The authors argue that oxytocin is commonly used to improve the process.
Other medical interventions that can be suggested are breaking the waters. However, the midwives should consider the emotional well-being of the woman and help her overcome the stress, which can be done using aromatherapy or a warm bath. Other suggestions include exercise, for example, using a ball that can help enhance dilation. When choosing a method, the patient’s preferences should be considered. Hence, the two ways to progress in labor are – using labor hormone oxytocin and non-medical interventions aiming to help the women relax.
The common cause of a premature urge to push is the pressure on the pelvic floor. In general, the urge to push is a result of Ferguson’s reflex’ triggered by the pressure on the nerve receptors located on the pelvic floor. This can happen both before and after the full dilation of the cervix. Some evidence suggests that this phenomenon can lead to “cervical edema, cervical lacerations or maternal exhaustion,’ suggesting that women should be discouraged from premature urge to push (Tsao, 2015, p. 5).
There is limited evidence discussing the premature urge to push. In most cases, an individualized plan is recommended. Methods, which can be used to cope with this issue, are – position change in which the women are positioned on her hands and knees and the breathing method pant and bow (Tsao, 2015). In some cases, medication for pain relief is recommended to mitigate the early push.
Emotional dystocia is a term that describes a prolonged labor process, which, when compared to the normal progression of labor, is more extended. This issue is a result of a trauma, in some cases, a previous traumatic delivery or other physiological problems that the mother is experiencing. The typical indicators are prolonged labor that is not a result of other medical implications. Predisposing factors are stress experienced throughout labor or previous labor experiences that can cause trauma (King et al., 2018). However, previous labor is not the only psychological issue that can cause this issue, and any trauma affecting the patient can contribute to emotional dystocia.
Since this is an emotional issue, the primary task of a midwife is to identify emotional dystocia using the indicators above and help calm the patient. Management options include discussion and support provided by the midwives. In essence, it is best to discuss the fears of possible psychological issues that a woman can have before labor to address the stress. Overall, this essay answered the three critical questions about the labor progress, premature urge to push, and emotional dystocia.
References
Gabbe, S. G., Niebyl, J. R., Simpson, J. L., Landon, M. B., Galan, H. L., Jauniaux, E. R., … Grobman, W. (2016). Obstetrics: Normal and problem (7th ed.). Amsterdam, Netherlands: Elsevier.
King, T. L., Brucker, M. C., Osborne, K., Jevitt, C. M. (2018). Varney’s midwifery (6th ed.). Burlington, MA: Jones & Bartlett Learning
Tsao, N. (2015). Early pushing urge before full dilation: A scoping review. Web.