Signs for the midwife to check in stage 1
If the mother is in late labor, she can probably make it to the end of the birth even
if she is very tired. She needs encouragement and patience.
If the mother is exhausted, and contractions stop for more than 1 hour, or if
they start but she does not make progress, take her to a medical center.
B aby doe s no t fi t thro ugh the mo the r’ s pe lv is
If the baby is in a difficult position, or is too big to pass
through the mother’s pelvis, the baby cannot come out.
The mother will labor until the womb tears and she dies
of bleeding inside, or until she and the baby die of
exhaustion. Even if she does give birth eventually, she
may have serious damage to her vagina, bladder, or bowel
(fistula, see page 273).
A baby is less likely to fit when:
• the mother is very young and her pelvis is not fully grown.
• the mother did not get enough good food when she was a child
(this can make her grow up to be unusually small or to have a
• the mother has a deformity of the pelvis.
• the mother has diabetes.
• the baby is big, or grew unusually fast during pregnancy.
• the baby’s head was still high and could be felt above the pubic
bone when labor started.
• the mother had a hard time
pushing out her last baby, and
this one is bigger.
• the mother has been in labor for 8 to
12 hours with no progress. (If medical
help is far away, go sooner.)
You have been in labor all day
and this baby feels even bigger
than your last. I think we
should go to the hospital.
Because you cannot know for sure if the baby
is too big to fit, let the mother labor a few hours
and see what happens. Most of the time, even a
very big baby comes out fine. But if the woman
has been in strong labor for more than 12
hours without signs that the birth is near, get
medical help. She may need to have a cesarean
surgery for the baby to be born.
A Book for Midwives (2010)