What is Dystocia? Obstructed Labor Signs, Symptoms & What to Do

You may have heard of labor, fetal, or shoulder dystocia. So what is this exactly? And what does it mean for mother and child? Let’s dive in.
Dystocia comes from the Greek words dys (“difficult”) and tokos (“birth”).

It’s common — happening in about one in five births.

So if it happens to you, know that you’re definitely not alone.

So what causes it?

How can your birth team help?

And can you prevent it?

We’ll take you through everything you need to know.

In this article: 📝

What is dystocia?

The dystocia definition is “a difficult or obstructed labor.”

So it’s essentially an umbrella term that covers a range of labor challenges.

These include slow cervix dilation, the baby descending too slowly, and the baby’s shoulders getting stuck after their head is out.

(This last one on this list is considered a medical emergency — more on this below.)

In the US, 31% of births are by cesarean.

And dystocia is one of a handful of primary reasons for a c-section.

That’s because prolonged labor comes with increased risks, both for the mother and baby.

What are the 3 types of dystocia?

There are three types of dystocia — fetal, cervical, and shoulder.

Fetal dystocia

Fetal dystocia is when the fetus is either too large for the pelvic opening or is in a position — like the breech position — that makes delivery difficult.

What medical professionals call vertex occiput anterior is when a baby’s head is downwards and facing towards the mother’s back.

This is a good position for them to be born in.

(It’s worth noting that the baby usually settles into this position by about week 36 of pregnancy but can still move around after this.)

If they’re in a different position, labor and birth can be more of a challenge.

Know that even if your little one has got creative with their positioning, a healthy birth is still very likely.

Together with your healthcare team, you’ll make decisions about what’s best for you and your baby.

This may mean that you have to steer away from some of your birth preferences.

And while this may not feel ideal, what matters most is that your baby can be delivered safely into your arms.

Cervical dystocia

This type of dystocia happens if the cervix doesn’t dilate enough during labor (dilation means opening up) due to uncoordinated uterine activity or short and infrequent contractions.

This obstructs the exit route for a vaginal delivery, making it harder for the baby to make their way out.

Shoulder dystocia

When one or both of a baby’s shoulders get stuck behind the mother’s pelvic bones during vaginal delivery, it’s referred to as shoulder dystocia.

It’s a rare condition, only occurring in between 0.15 to 2% of births.

Shoulder dystocia is a medical emergency that is dangerous for both mother and baby.

But if this happens to you, there’s so much your birth team can do to help.

Treatment may involve widening your pelvis or moving the baby’s position.

In more severe cases, your doctor might need to make an incision in the pelvic area or deliver your baby via cesarean.

What are the 3 causes of dystocia?

There are many different factors that could lead to dystocia.

Some are related to the baby (fetal factors), and some to the mother (maternal factors).

Fetal factors

• The baby weighs more than 4.5 kg.
  
• The position that the baby is in, for example, a breech or transverse position, makes birth more challenging.

Pelvic passage factors

The pelvic opening is too small, or the pelvic shape is long and oval rather than round-brimmed.

Uterine factors

If contractions are short or infrequent, labor can be prolonged and difficult.

It’s important to note that labor can be more difficult for first-time mothers as their bodies work out how to do this thing!

So research suggests that dystocia may be more common in first births.

What is a risk factor for dystocia?

Shoulder dystocia can happen to anyone, but there are a few factors that can increase the chances.

Here are some key ones:

• A previous experience of shoulder dystocia
  
• Preexisting diabetes or gestational diabetes
  
• A BMI over 30 kg/m2 or excessive weight during pregnancy
  
• Fetal macrosomia (a much bigger baby), particularly if they’re more than 4.5kg
  
• Being pregnant with multiples
  
• Pelvis shape

What are the symptoms of dystocia?

While there are factors that can lead to dystocia, there aren’t exactly any symptoms of it, and it’s difficult to know ahead of time if it will occur.

This is particularly true of shoulder dystocia.

If you’re preparing for a vaginal birth, unfortunately, things might not always go as planned, and it can help to be prepared for this.

Understanding the stages of labor and how things progress is valuable.

How is dystocia treated?

How dystocia is treated depends on the type and cause.

If the issue is with uterine contractions, then oxytocin can help.

Oxytocin is a hormone that plays an important role in childbirth and breastfeeding.

It occurs naturally in our bodies.

In certain situations, you can be given an oxytocin injection to help with labor.

Physical maneuvers can also be used to reposition the baby if needed.

Other options are operative vaginal delivery — where a doctor will use forceps or a vacuum extractor to help get the baby out — or cesarean delivery.

How do you prevent dystocia?

There are some factors that are out of your control, such as the shape of your pelvis or how big your baby is.

In most cases, it can’t be prevented.

But to optimize your health and lower your risk, you can try to maintain a healthy weight throughout your pregnancy and manage diabetes if you have it.

Also, it’s always a great idea to chat with your obstetrician or midwife before you give birth to make sure you feel as prepared as possible.

Dystocia: the final word

It’s an understatement to say that giving birth can feel overwhelming.

And a lot of it is out of your control.

But preparing for labor, both physically and mentally, can really help.

Feeling ready helps build confidence.

And research has shown that this can help you have a positive birth experience.

Mama, you’ve got this!

And if you need support along the way, your Peanut community is here for you.

All the best. ❤️