Why a rapid labour might not be a good thing

Delivering quickly may sound ideal, but a speedy labour isn’t always safe for mother and baby. Learn why.

As a new mum-to-be, you’re probably anxious about giving birth, even after taking parenting classes and reading every baby book available.

We don’t blame you! Mums-to-be have a host of reasons for fearing labour and delivery, especially since delivering a baby may involve a lot of pain and discomfort. You may also have heard scary stories of other mums enduring a prolonged labour, and are dreading it might happen to you.

You’ve probably researched ways to shorten your labour, or looked for tips to an easier, quicker delivery. After all, the shorter the delivery, the better, right?

However, while a speedy labour may be the dream of many mums-to-be, it’s not always a good thing. Just like giving birth too early, delivering too fast has complications ― including potential risks for both you and your bub.

SmartParents asked experts as to what rapid labour entails, how it differs from regular labour, possible risks, and how to cope if it happens to you.

Just like giving birth too early, delivering too fast has complications ― including potential risks for both you and your bub.

What exactly is rapid or precipitous labour?

“Rapid labour (also referred to as precipitous labour) is defined as expulsion of the foetus less than threehours from the start of regular contractions,” explains Dr Christopher Ng, obstetrician, gynaecologist and medical director at GynaeMD Women’s & Rejuvenation Clinic.

In contrast, in normal or regular labour, the baby is born between three and 30 hours after regular contractions begin in women who have never given birth before. In women who have given birth once before, the baby arrives three to 15 hours after regular contractions start, he explains.

Whilst the prevalence of rapid labour in Singapore is not known, a 2014 study by the Centers for Disease Control and Prevention (CDC) in the US reports that over 21,000 or 2 per cent of 945, 180 live births were linked to rapid labour.

How do doctors identify an instance of rapid labour?

Dr Pamela Tan, an ob-gyn at Thomson Medical Centre, notes, “Unlike the gradual buildup of contraction frequency and pain, fast labours are often intense from the start. Contractions come in very close, fast and furious, with shortened recovery time between each contraction.”

The mother may have the urge to bear down as the head descents quickly, she adds. This urge mimics the need for a bowel movement, as pressure being placed on the rectum.

Why does rapid labour occur?

Several factors increase its likelihood. “There is some suggestion that rapid labour may run in families,” notes Dr. Ng. “Induction of labour may also increase the risk, as well as maternal high blood pressure.”

Dr Tan adds that rapid labour is often seen in young mothers, teenagers, and women who’ve had one or more children. She describes the other causes as the four Ps of vaginal birth:

* Power: Strong, forceful uterine contractions.

* Passage: A birth canal that is compliant/soft/capacious.

* Passenger: A smallish-sized or pre-term baby. “The smaller the baby, the easier it is for the baby to pass through the birth canal,” Dr Ng notes.

* Pain (lack of): Not feeling as much contraction pain during the first stage of labour. Women don’t realise that they are dilating and going through the first stage of labour until they feel the urge to push.

What are the risks associated with rapid labour?

In addition to the quick intensity of pain being harder on a mother’s body, rapid labour also presents other physical risks.

Dr Ng points out, “Rapid labour has been associated with a higher risk of tears and bruising of the cervix, vagina and perineum. “

Other complications include:

a. Postpartum haemorrhage (excessive bleeding after delivery) resulting from uterine atony (uterus fails to contract properly)

b. Placental abruption (separation of the placenta before the birth of the baby); and

c. A retained placenta.

Another drawback of a quick labour is that the mum-to-be isn’t able to get an epidural or even make it to the hospital in time. This puts the mother and baby at risk of an unsterilised delivery.

Nevertheless, Dr Ng assures that most women with rapid labour have few problems with delivery, since complications happen during normal labour as well. However, rapid labour us far more likely to give rise to emotional side effects.

“Delivering unexpectedly and unaided outside the hospital can be a scary experience for the mother.”

Dr Tan says, “Delivering unexpectedly and unaided outside the hospital can be a scary experience for the mother.”

Not having one’s spouse alongside to provide support, and having to abandon one’s original birth plan can understandably trigger feelings of anxiety and panic. The sudden onset and intensity of labour pains is also cause for emotional trauma, and may leave one scarred by the experience of childbirth.

What to do if you experience fast labour

As stress-inducing as it is, the key to a safe delivery is to take control of the situation, rather than let it dictate your emotional state. Do this by keeping calm, breathing and meditating to lower your anxiety levels.

Call for an ambulance and direct them to your hospital of choice as soon as you experience any labour contractions, Dr Ng advises. Also, ask for analgesia (if it is in your birth plan) as soon as you are in labour ward.

He advises, “It’s a good idea to pack a bag well beforehand too, so that you’re ready with whatever you need to bring to the hospital.”

If you’re unable to get to the hospital or help doesn't come in time, don’t panic! Follow your instincts and bear in mind that your body is equipped to do this (even without doctors and nurses by your side!).

“Deliver on a cushioned surface with a towel and keep your newborn warm with skin-to-skin once delivered,” Dr Tan instructs. “There is no rush to cut the umbilical cord till you get to a hospital and are assessed by medical personnel.”

Can you prevent rapid labour?

Unfortunately, both ob-gyns agree that one cannot prevent rapid labour, especially as it’s difficult to pinpoint the direct causes.

However, you can prepare, especially If you have a strong family history of rapid labour. Ensure that you have a birth partner such as your husband, doula, domestic helper or relative on standby closer to your due date. If they can come to your aid at a moment’s notice, you won’t have to give birth completely unassisted.

Photos: iStock

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