Stuck at 9cm

  1. Hey there. I was just wondering if there is anything that can be done about a cervix that won't dialate past 9cm. We had this happen the other day, and the woman ended up having a C/S. Is there anything your docs do for this? Does it work? Thanks in advance!
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    About JenTheRN

    Joined: Aug '04; Posts: 215; Likes: 226
    Peri-Operative RN; from US
    Specialty: 10 year(s) of experience in PERI OPERATIVE

    14 Comments

  3. by   SmilingBluEyes
    I have non-anesthesized moms Walk, Squat, rock, and move move move.......the worst place to be is on one's back. In moms with epidurals, I flip all around the bed, first on one side, then the other, (as the mom and fetus will tolerate)----then I also have them sitting up as high as they can tolerate it, to allow the fetal vertex to "rotate" and descend. Movement is key to getting a baby to "corkscrew" into the right position and allow for progress.

    In some cases, a vertex is acynclitic ("cockeyed") or persistently OP, and the baby will not advance further, hence, progress gets "stuck". If that happens, not much anyone can do, if you have tried all of the above.
  4. by   JenTheRN
    Thanks for the reply. We tried hydrotherapy, and our doc tried pit...to no avail, just made her already bad contractions worse. Have your ever heard of trying to push past 9? Our pts tend to stay in bed. I have to remember that they are mobile beings! The babe looked good the whole way through, and I bet walking/moving around would have done her some good. It just seemed like there was something else we could have done. I think the doc wanted a C/S just to have the labor over with.
  5. by   ayndim
    Quote from JenTheRN
    Hey there. I was just wondering if there is anything that can be done about a cervix that won't dialate past 9cm. We had this happen the other day, and the woman ended up having a C/S. Is there anything your docs do for this? Does it work? Thanks in advance!
    How long was she "stuck" at 9?
  6. by   SmilingBluEyes
    that was my next question.......how long?

    and no, we do not have people "push past 9", just a very friable, effaced and moveable "rim", or anterior lip, if possible--- and only if it disappears when the first push is attempted...too much aggression on the cervix CAN result in UGLY lacerations, which can bleed massively, believe me. Once you see this, you never, ever forget it.

    All in all, the best way is to let things progress as nature intended....but that is not what happens in so many inductions/hospital births today, I know.
  7. by   JaneyW
    Am I misreading or do you let people walk at 9cm?!!?? I am a big fan of the straight up position if the baby can tolerate it. We are such slaves to our stupid fetal monitors and they don't always pick up well in some positions.
  8. by   ayndim
    Heck with my 1st I walked into the birthing center to get checked and was 9cm. Guess because I was so relaxed and mobile at home things went quick (labored almost 3 hours at home). I had to transfer to the hospital b/c of meconium and walked around the room and was mobile there too. I pushed in the shower, on the toilet and standing near the bed. (She was sunnyside up so I had 5 1/2 hours of pushing but we did it!) Heck they can't forcebly strap you down. They didn't even try with me. Gotta love the MW's.
  9. by   JenTheRN
    She was at 9 for about 4 or 5 hours before they decided to go C/S.
  10. by   JenTheRN
    And thanks for the replies guys. We have a small hospital and only about 20-30 deliveries a month. Don't see this very often.
  11. by   BETSRN
    Quote from JaneyW
    Am I misreading or do you let people walk at 9cm?!!?? I am a big fan of the straight up position if the baby can tolerate it. We are such slaves to our stupid fetal monitors and they don't always pick up well in some positions.
    Of course they can walk. People push standing up, remember? Even if you do not have telemetry monitors, you still have the length of the cords. That's plenty of length to stand, squat, sit in a chair, etc.
    We have gotten away from letting women do NATURAL things.
  12. by   JaneyW
    Quote from BETSRN
    Of course they can walk. People push standing up, remember? Even if you do not have telemetry monitors, you still have the length of the cords. That's plenty of length to stand, squat, sit in a chair, etc.
    We have gotten away from letting women do NATURAL things.

    You know, I think it's because most of my patients have epidurals and they can't walk. I do manage to get them to move all over the bed although they often dislike me for that. We had one lady that was 'stuck' and we placed her on her knees and forearms with her butt stuck up in the air. She did this even with an epidural and delivered about 30 minutes later.

    I guess I just have visions of babies dropping out on the floor and such.
  13. by   JudithL_in_NH
    Quote from JenTheRN
    Hey there. I was just wondering if there is anything that can be done about a cervix that won't dialate past 9cm. We had this happen the other day, and the woman ended up having a C/S. Is there anything your docs do for this? Does it work? Thanks in advance!
    I got "stuck" with my first, and the midwife had me sit on the toilet for a while--was fully dilated within a few contractions. Just a psych thing, I think--it's a place where we're used to "opening up."
  14. by   midwiftippitoes
    I agee with mobility , was her bladder full if she had an epidural that could have impeded descent etc. With epidurals the women dont have urges to void let alone push. After doing all that you could dont feel bad ( and I know that we do) if they wind up in a c/s. What I am havinga problem with is c/s on demand. How about that?
    The greatest joy is being a mother, the second greatest joy is being a midwfe
    Last edit by midwiftippitoes on Jan 22, '05 : Reason: mispelling

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