By Dr. Santoshi Nandigam, Senior Obstetrician & Gynaecologist - THE BIRTHWAVE, Nungambakkam, Chennai
From the very first contractions to the moment a baby enters the world, labour is a journey of hope, expectation and sometimes-unpredictability. For many expectant mothers in Chennai and across India, the ideal is a “natural” vaginal birth, a milestone of motherhood.
Yet in some cases, nature needs a little help - and a safe, timely intervention becomes the key.
One of the critical challenges we face in obstetric care is non-progress of labour (also called failure to progress or prolonged labour). Recognising it and making the correct decision - sometimes a caesarean section (C-section) - can mean the difference between anxiety and a healthy outcome for mother and baby.
In this post, we’ll cover:
What is non-progress of labour and how to recognise it
The risk factors and underlying causes (the “3 P’s”: Power, Passage, Passenger)
Why and when a decision to deliver by C-section is made
What this means for expectant mothers in Chennai
How our clinic approaches these situations with safety and compassion
When to talk to your doctor and what questions to ask
Key terms: labour management, non-progress of labour, caesarean section decision, normal delivery, high-risk pregnancy, obstetric care in Chennai, maternal & fetal wellbeing.
What is “Non-Progress of Labour”?
In simple terms, non-progress of labour means labour that does not proceed as expected - even when the mother is in active labour and both she and baby are being monitored.
Specifically, the cervix is not dilating, or the baby is not descending despite adequate contractions.
Medical definitions:
Labour may be classified as protraction (slower than normal dilation/descent) or arrest (complete cessation of progress).
In the active phase (from 6 cm dilation), if there is no cervical dilation after 4 hours of adequate contractions, it may be considered an arrest.
According to the Cleveland Clinic, labour lasting over 20-25 hours for a first-time mother may be considered prolonged.
Why it matters:
Prolonged or obstructed labour increases risks - for the mother (infection, exhaustion, uterine rupture) and for the baby (fetal distress, oxygen deprivation).
Understanding the “3 P’s” of Labour: Power, Passage & Passenger
When labour isn’t progressing, obstetricians evaluate three key factors: Power (uterine contractions + maternal effort), Passage (the maternal pelvis and birth canal), and Passenger (the baby’s size, position, presentation).
Power
Are contractions strong and frequent enough?
Sometimes, the uterus contracts but not effectively.
Monitoring tools include toco-dynamometry or intrauterine pressure monitoring.
If contractions are weak, oxytocin augmentation may be used.
Passage
The maternal pelvis must allow safe passage for the baby.
Cephalopelvic disproportion (CPD) or abnormal pelvis shape can hinder progress.
Malpositions (like occiput posterior or transverse) also delay descent.
Passenger
A large baby (macrosomia), or abnormal presentation (breech, transverse lie), can cause non-progress.
These cases may require repositioning or a C-section for safety.
When Should a Caesarean Section Be Considered?
For many mothers, “C-section” can sound intimidating. But it’s important to remember - a C-section is not a failure, it’s a life-saving medical decision when labour doesn’t progress safely.
Common Indications:
Active phase arrest: No cervical dilation after several hours despite good contractions.
Failure to descend: Baby not moving down after full dilation.
Fetal compromise or maternal exhaustion/infection.
Cephalopelvic disproportion or malpresentation preventing safe vaginal delivery.
Why timely decisions matter:
Prolonged labour can cause infection, haemorrhage, uterine rupture, and fetal distress.
Early recognition and timely C-section improve outcomes.
At THE BIRTHWAVE, Chennai, we ensure transparent communication and evidence-based protocols so the decision is always shared and informed.
Non-Progress of Labour: What Expectant Mothers in Chennai Must Know
1️. Choose your obstetric care team early
Find a gynecologist skilled in both vaginal deliveries and managing labour complications.
Ask about C-section rates, non-progress management protocols, and whether there’s an in-house anaesthesiologist.
At THE BIRTHWAVE, our in-house anaesthesiology support ensures immediate readiness for emergencies - a critical difference during labour.
2. Understand your birth plan - but stay flexible
Aim for a natural birth, but be prepared for contingencies.
Include a clause in your plan: “If labour does not progress by X hours, we’ll consider C-section.”
Discuss all scenarios ahead of time to avoid panic during labour.
3️. Stay fit and informed
Maintain a healthy weight and attend all prenatal visits.
Movement and prenatal yoga can help your pelvis adapt and improve labour progress.
THE BIRTHWAVE offers online prenatal yoga sessions - call us to know more!
4️. Recognise signs of non-progress
No further dilation or descent.
Fetal heart rate changes or maternal exhaustion.
Your doctor will track this on a partograph (dilation vs time chart).
5️. If a C-section is advised
Understand it’s a safe and common procedure.
Ask about anaesthesia, recovery, and skin-to-skin contact post-surgery.
We prioritise rooming-in, early bonding, and post-op comfort at THE BIRTHWAVE.
Real-Life Example (Anonymised)
Ms. S, a 28-year-old first-time mother from Chennai, had stalled dilation at 6 cm for over 4 hours despite strong contractions. After oxytocin and positional changes failed, we proceeded with a C-section.
The result: a healthy mother and baby, and a family that understood the decision was medically right - made at the right time.
Takeaway: timely recognition, open communication, and skilled care make all the difference.
Why Choose THE BIRTHWAVE Clinic in Chennai
Evidence-based maternal-fetal monitoring
Team trained for both vaginal and C-section deliveries
Transparent, supportive counselling
Post-delivery comfort and bonding-focused care
We believe every birth should feel supported - no matter how it unfolds.
Common Myths & Facts
Myth: “If labour doesn’t progress, I’ve failed.”
Fact: You haven’t. Labour can stall for many reasons - your safety matters most.
Myth: “Patience alone can prevent C-section.”
Fact: Delaying too long can be risky - balance is key.
Myth: “If I want a natural birth, I must refuse C-section.”
Fact: Flexibility keeps both you and baby safe.
Questions to Ask Your Obstetrician
What’s your approach if my labour slows?
How do you decide when to move to C-section?
What safety protocols do you follow?
What is your C-section rate in first-time mothers?
How will you support me after delivery?
Final Thought
Your birth experience matters - not just in how you deliver, but how you feel about it afterwards. A healthy, informed mother and a thriving baby are the ultimate goals.
Be flexible, trust your medical team, and choose a clinic that values your voice and safety.
Ready to Talk About Your Birth Plan?
If you’d like a detailed consultation about labour monitoring, birth plan options, or non-progress management - we’d be happy to connect.
📞 Call us: +91 9363031925
📍 Visit us: THE BIRTHWAVE, Nungambakkam, Chennai
🌐 Book online: https://thebirthwave.com/contact-us/
Dr. Santoshi Nandigam, MBBS, MS (OBGYN)
Senior Consultant Obstetrician & Gynaecologist
THE BIRTHWAVE Clinic - Where Every Birth Is Cared for Like Family.
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