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The uterus's declining ability to contract may be a sign of disproportion between the pelvis and the baby, so it's wise to regard it with care. However, rushing to perform a cesarean section or use vacuum extraction or forceps is not always the answer. Caregivers should first try feeding the mother; allowing her to move freely and to change positions; and providing her with reassurance, pain relief or the positive influence of another woman, such as a doula or midwife.
As long as the fetal heart tones are reassuring, the caregiver usually can exercise patience and trust in the normal birth process. Medication and anesthesia such as an epidural block may affect labor in a negative or positive way. Pain relief may reduce stress levels and allow the mother to relax. Sometimes, a woman will reach complete dilatation relatively soon after receiving a pain reliever. On the other hand, poorly timed pain relievers or epidural anesthesia may reduce the uterus's ability to contract, and prolong labor.
Your Baby's Journey During Labor
During the process of labor and birth, the fetus has to navigate a series of tight spaces. The normal pelvis has a fairly roomy inlet, a tight midplane and a generous outlet. The baby moves into the inlet (engagement) before labor in the first-time mother and during labor in women who have delivered one or more children. Once fully engaged at "zero station," the baby must rotate (with the help of powerful uterine contractions) to present the smallest diameter of the head at the mid-pelvis. Once she is at "plus one" through "plus four" stations, the baby rotates so the face is directly down (or up, in the case of a posterior baby). The muscles of the pelvic floor, combined with the curvature of the sacrum and the mother's pushing effort, all work to help the baby descend.