Signs for the midwife to check in stage 1
If there are no signs of progress, or if the labor lasts longer than 12 hours,
something may be wrong.
Note: Never make a woman feel guilty if her labor is long or hard.
Encourage her — do not blame her.
Some causes of slow or stuck labor in stage 1 are: the mother is afraid, upset, or
tense, or she has become exhausted. Labor will also slow down or get stuck if the
baby is in a difficult or impossible birth position, or if the baby cannot fit through
the mother’s pelvis.
Mother is afraid, upset, or tense
Fear and tension can slow labor. Here are some common causes of tension
• The physical pain of labor is frightening.
• This is a first baby.
• The mother’s last baby was born dead, or died later.
• The mother does not want this child.
• The mother has no husband, partner, or family to help her.
• There are family problems.
• The mother was abused sexually as a child or as an adult.
Unfriendly family members or neighbors can also make women much more
tense and afraid, and should not attend the birth.
Good labor support and companionship can often reduce fear and tension and
help labor to pick up. Try talking with the mother. Complicated feelings, like
loneliness or not wanting a baby, can slow a labor. Compassion and letting her
talk about her fears can help a mother find comfort.
Help the mother relax her body. If her arms, legs, and face are relaxed, it will
help her cervix open, and help labor move forward. You can give her a massage, or
a warm bath, or apply warm cloths to her body.
Remember to treat the woman with care and respect.
doing so well,
Find other ways to help her feel calm and safe:
• Help her welcome the contractions. When
each contraction begins, ask her to take a
deep breath and let her muscles relax
(see page 170 for ideas about breathing).
• Tell her what good work she is doing.
Remind her how strong she is.
• Ask her to picture the cervix or the womb
opening up and letting the baby out. Some women
imagine other things opening — like flowers blooming.
• Remind her that every contraction helps bring the baby.
A Book for Midwives (2010)