14 Aug · Karen Melton · No Comments

Understanding “Failure To Progress” and How it Can Lead to a Cesarean Section

If you are choosing a hospital birth it will help you to avoid a cesarean section (c-section) if you understand what Failure To Progress (FTP) means, and how it leads to c-section.

What is Causing Failure To Progress?
FTP has been created by medical doctor’s, so what does it mean? The medical profession, long ago, did a study on how long a labor should take, and they created an average for all women, this is the measure by which you are being told you are failing. FTP means that you are not laboring within their study guidelines; this has become a normal way for assessing birthing women in hospital. Naturally, there are wide ranges of experiences within birthing, and that includes how long each mother takes to give birth. There is no ‘normal’, and it is not something that can be measured. This false measure is not helpful to moms or babies. Being told you are failing during birthing can be demoralizing and disempowering for a woman who is incredibly vulnerable and doing her best, and who is progressing very well.

FTP often indicates that a mom has come into the hospital either early in her labor, when her labor began, or she has come in to have her labor induced (see Induction article – this is becoming more common and is putting c-section rates up even higher). In the hospital your birthing experience is going to be on their clock, not yours and your baby’s. Obstetricians and labor ward staff do not understand how to operate on ‘baby-time’, unlike midwives who have learned to be patient and bring their knitting. Hospitals often want to speed everything up. It could be argued that FTP should be called ‘Failure To Wait’. This speeding up is influenced a lot by doctors wanting their patients to birth during their work day, and not in the middle of the night. To manage birthing this way requires a great deal of intervention on their part. Being a respectful birthing attendant is about waiting, patience, and holding respectful space. The tools that medical birthing has to offer are drugs and medical interventions, mainly to get things moving faster. Conversely, the drugs, such as epidurals, often have the unfortunate affect of slowing labor down, or bringing it to a halt, and then further interventions are used to get it going and speed it up. FTP can also mean that you are not going fast enough for the doctor, and that has nothing to do with you or your baby.

If you want to actively avoid a c-section you need to know that the earlier you go into hospital in your labor the more medical interventions you are likely to receive. For this reason induction should always be avoided unless truly medically indicated. Inductions have become more popular because they are very convenient for doctors, and some moms opt for them because they want to be in control of when their baby comes. They are not a good option. The more interventions you receive the higher possibility there is for a c-section; the longer you are in hospital the more interventions you will receive, so this makes induction a high factor in c-section births because you are in hospital before you are even in labor. One intervention leads to another; it is a cascade affect. The more you have, the more likely to enter into the dreaded FTP zone which often leads to c-section.

Around 70% of women are given Pitocin to speed labor up or induce birth early (see Pitocin article). You may constantly be offered pain medications even if you have specified a natural birth. There is often no medically indicated need for you to be given any drugs, you were probably progressing normally and would have been fine without them. Pitocin speeds everything up, or gets contractions going before you and baby are ready. Baby starts the contractions when she/he is ready, birthing is not just about the mom being ready.

Physical Restrictions: Another contributor to FTP is the physical restrictions often put on birthing women in hospitals. Moving around and changing positions is such an integral part of normal, healthy birthing. Birthing women need to be free to move around, to drink, and eat; to follow their own intuition, and listen to the wisdom of their own body and instincts. Lying on your back is the worse position you can be in to give birth, it impedes the babies descent down the birth canal making it harder for you and baby, and doesn’t utilize gravity. It is convenient for the doctor/hospital staff and that is the only reason it is used. This restriction of movement undermines your innate connection to your own, and your babies needs, during birthing. It is so important for healthy birthing that the mom be supported in every way to move and change position as she sees fit, unless there is a real reason why she should not be doing so. Fetal monitors and intravenous drips (for quick drug intervention) contribute to walking and moving restrictions, and positions that you can birth in.

Fear is Not Working For Us:
Women often go to hospital to birth because they are scared either about birthing itself, or of doing it at home. Unfortunately, I regularly hear that once in the hospital women are frightened by doctors and nurses who use fear to gain compliance and coerce their patients, e.g. “if you don’t do this your baby will die” is quite a common one. Your doctor may even frighten you before you get to birthing. Fear contracts our whole body and being, and puts us in the opposite state required for successful, empowered birthing. We must feel relaxed, safe, in charge, and open. Fear closes us and tightens everything up. For this reason hospitals have become the worst places for women to birth because the contraction caused in our systems by fear results in what will later be called FTP, possibly culminating in a c-section. This failure is often the failure of the medical environment, and has nothing to do with birthing mom’s and their capabilities to give birth. An ideal birthing environment should be quiet, safe, low lighting, and respectful attendants who support the moms instinctual knowing.

Support & The Right Space:
For the miracle of birth to happen a woman and baby must be deeply supported and totally empowered in a completely safe environment, with the support of loved ones, and with privacy if mom requires it. Birthing is a deeply vulnerable, sacred and intimate event. Research has shown that birthing outcomes are vastly improved if a birthing mom has continual care from one consistent person (doula’s are fulfilling this role). Some mom’s do manage to have a natural birth in hospital with the help of doula’s and extremely supportive and protective spouses, if they have a very strong desire to have their own birth the way they want it. This can take a lot of work and forethought because you are essentially going into a medical birthing environment and asking them not to do what they do.

If home birth doesn’t appeal to you I encourage you to take a look at birthing centers as an alternative. Why not meet some midwives and research the reality of home birth too? Make sure that the information you have about it is accurate. The obstetrical profession has been trying to get rid of midwives for many decades, make sure your information is impartial. I firmly believe home birthing and birthing centers to be much safer and more conducive to birthing that is natural, pleasurable, ecstatic and empowering. Some Birthing Centers will offer you all the support of a midwife even if you birth in hospital, so call yours and find out what they are offering.

Birthing is a sacred rite of passage for both moms and babies.

Please read “How To Be Prepared For a C-Section’

© 2016 Karen Melton

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