If there is a delay in labour

Delay in labour is when the labour is taking longer than expected. It can happen at any stage of labour. You should be offered support and pain relief, and advised to move around or change position. You may need to be transferred to an obstetric unit if you are at home or in a midwife-led unit, so that extra care is on hand if needed. Sometimes it is recommended that the labour or birth is speeded up if there is a chance that the delay may cause problems for you or your baby.

Delay in the first stage

If the first stage of labour is slow, your midwife or doctor may suggest breaking your waters (sometimes called 'artificial rupture of the membranes') if they haven't broken already. This will make your labour shorter and may make your contractions stronger and more painful. Whether or not you agree to have your waters broken, you will be advised to have regular vaginal examinations to see how far along your labour is.

You may also be offered a drip with oxytocin (a drug that makes your contractions stronger). Oxytocin will bring forward the time of birth. If you have oxytocin you should also be offered an epidural, and electronic monitoring will be recommended. You will be advised to have regular vaginal examinations.

Delay in the second stage

If you are having your first baby and your contractions are weak at the start of the second stage, you may be offered an oxytocin drip to make your contractions stronger. You should be offered an epidural at the same time.

If the second stage of labour is slower than normal, you should be offered a vaginal examination. Your waters may then be broken (with your agreement) if this hasn't already happened. An obstetrician should assess you, and you may be offered an oxytocin drip to speed up your labour (and an epidural). A midwife or doctor should continue to assess you every 15 to 30 minutes. You should be offered support and encouragement, and asked whether you would like more pain relief.

Instrumental birth and caesarean section

If the second stage of labour goes on for longer than expected, you may be offered a forceps birth or a ventouse birth – sometimes called an 'instrumental' or 'assisted' birth. You should be advised to have an epidural or a spinal anaesthetic, or effective pain relief if you do not want an anaesthetic. If a vaginal birth is not possible, you will be advised to have a caesarean section (see other NICE guidance).

It may also become necessary for the birth to happen quickly if there are concerns about you or your baby. This might mean an instrumental birth or a caesarean section, depending on how quickly your baby needs to be born. Your midwife and obstetrician should explain why the birth needs to happen soon and what the options are.

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