Precipitate labour is very important for Midwives and Obstetricians to know what to do in such situation. Hence, in this article, we shall discuss precipitate labour, its causes, management and complications. We shall also consider back labour .
Most women especially primigravidae do not want to waste time in labour and experience that excruciating pain. They want everything speedily so that they could be free and have their baby. However, they fail to know that labour associated with high speed has many risk factors to both mother and baby.
Table of Contents
What is precipitate labour?
Precipitate labour is a labour that lasts for fewer than three (3) hours. This trial of labour often makes women give birth in the church, market place and so on. Those who thought were smart and started rushing to hospital, would be born on their way or at the hospital gate. Such babies are described as “born before arrival”.
Risk factors for rapid labour
- Large pelvis
- Previous precipitate labour
- Small fetus in a favourable position
Effects of the labour on the mother
- Increased risk of uterine rupture from intense uterine contractions.
- Loss of coping abilities
- Lacerations (cervical. Vagina and perineal) due to rapid, descent and birth
- Post-partum haemorrhage due to undetected laceration and inadequate uterine contractions after birth.
Feto-neonatal complications of precipitate labour
- Fetal distress or hypoxia due to utero placental circulation from intensive uterine contractions
- Cerebral trauma due to rapid descent through the cervix and giving birth in an unconducive place e.g. toilet seat etc…
How to manage a woman with precipitate labour
A woman with needs close monitoring and preparations for emergency delivery to ensure safe outcome for mother and baby. Proper history taking will help the nurse educate the woman on proper birth plan to come to facility as early as possible.
- During labour, the midwife’s observations of factors like
- Accelerated cervical dilation and fetal descent
- Intense uterine contractions with little relaxation in between contractions.
Precipitate Labour Vs Back labour
About one-thirds of women in labour report that their backs hurt during labour, more so than their abdomens. Sometimes, the pain of back labour does not go away during the break in uterine contractions, and this is often blamed on the baby being in an occipitoposterior position(turned to face the mother’s front).
Ways to manage Back Labour
Below are the strategies for ameliorating the pain associated with back labour and also help move a baby out of the posterior position. Therefore, try them if your back is hurting more than your belly during labour.
- Hands and knees: This reduces the strains on your back and also helpful at making the contractions less painful and will encourage a baby to rotate if he is facing forward.
- Water birth: labour taking place in a tub or shower has shown to provide enormous relief for most women. Several positions including hands and knees can be used in the water.
- Placebo/ Sterile water injection: This therapy involves four carefully placed injections of water, just under the skin around the sacrum. Although not routinely used, it can provide an amazing relief from back labour without medication —“the placebo effect”.
- Ice packs : Use of an ice pack or cold compresses on the area of the back that hurts can help alleviate pain
Sacral massage/counter pressure: This involves steady, firm pressure or massage on the lower back based on maternal request. It helps to sooth pain through release of endorphins —body’s natural pain killer.