Stalled Labor (Failure to Progress)
Medically reviewed by Dr. Lisa Okafor, MD, FACOG · Board-Certified OB-GYN
Content reviewed against published ACOG, NIH, NICE guidelines
Last reviewed:
Your health matters just as much as your baby's. If you are dealing with stalled labor (failure to progress), here is what you need to know.
The short answer
Prolonged labor or "failure to progress" occurs when labor stalls or progresses more slowly than expected. It is one of the most common reasons for cesarean delivery, but many stalled labors can be successfully managed with position changes, movement, Pitocin augmentation, amniotomy, or time. Every labor has its own timeline.
Key takeaways
- Prolonged labor or "failure to progress" occurs when labor stalls or progresses more slowly than expected. It is one of the most common reasons for cesarean delivery, but many stalled labors can be successfully managed with position changes, movement, Pitocin augmentation, amniotomy, or time. Every labor has its own timeline.
- Usually normal when: Labor that is progressing slowly but steadily is not necessarily a problem
- Call your doctor if: Signs of fetal distress during a prolonged labor (your care team will be monitoring this)
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What Parents Should Know
According to ACOG, NIH, NICE guidelines, prolonged labor or "failure to progress" occurs when labor stalls or progresses more slowly than expected. It is one of the most common reasons for cesarean delivery, but many stalled labors can be successfully managed with position changes, movement, Pitocin augmentation, amniotomy, or time. Every labor has its own timeline. At Labor & delivery, labor progress is measured by cervical dilation, effacement, and the baby's descent. Current guidelines recognize that active labor may not begin until 6 cm dilation (previously thought to be 4 cm). First-time labors are often longer. If labor stalls, your provider may recommend walking, position changes, Pitocin to strengthen contractions, breaking the water, or rest. A cesarean is considered when these measures do not lead to progress and there are concerns about safety. It is generally considered normal when labor that is progressing slowly but steadily is not necessarily a problem. However, you should contact your pediatrician promptly if signs of fetal distress during a prolonged labor (your care team will be monitoring this).
Normal vs. Concerning
By Age
What to expect by age
Labor & delivery
Labor progress is measured by cervical dilation, effacement, and the baby's descent. Current guidelines recognize that active labor may not begin until 6 cm dilation (previously thought to be 4 cm). First-time labors are often longer. If labor stalls, your provider may recommend walking, position changes, Pitocin to strengthen contractions, breaking the water, or rest. A cesarean is considered when these measures do not lead to progress and there are concerns about safety.
Postpartum
If prolonged labor led to a cesarean or assisted delivery, processing the experience is important. You may feel disappointed, exhausted, or relieved. All these feelings are valid. Prolonged labor does not mean your body failed - babies can be in difficult positions, and many factors influence labor progress.
What to Tell Your Pediatrician
- Describe when you first noticed stalled labor (failure to progress) and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if you feel your labor has stalled and want to discuss options.
- Mention if you have been pushing for a long time without progress.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- Labor that is progressing slowly but steadily is not necessarily a problem
- First labors can take 12-20+ hours
- Cervical dilation is not always linear - it is normal to have periods of slower progress
- You feel your labor has stalled and want to discuss options
- You have been pushing for a long time without progress
- You are exhausted and need to discuss your options
- Signs of fetal distress during a prolonged labor (your care team will be monitoring this)
- Fever during labor suggesting possible infection
- You are unable to cope and need immediate support
What You Can Do at Home
- Keep track of when you notice stalled labor (failure to progress) — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that labor that is progressing slowly but steadily is not necessarily a problem — this is generally within the range of normal.
- At Labor & delivery, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Prioritize your own rest and nutrition. Accept help when offered, and do not hesitate to reach out to your healthcare provider.
- While monitoring at home, seek immediate care if signs of fetal distress during a prolonged labor (your care team will be monitoring this).
Related Conditions
Questions About Labor Induction
Labor induction is the process of starting labor artificially before it begins on its own. It may be recommended for medical reasons (such as post-dates, preeclampsia, or gestational diabetes) or may be offered electively at 39 weeks or later. Modern induction methods are safe and effective, though the process may take longer than spontaneous labor.
When Birth Does Not Go as Planned
It is very common for birth to unfold differently than planned. About 1 in 3 births in the US involve cesarean delivery, and many other births involve unplanned interventions. Feeling disappointed, sad, or even grieving the birth experience you envisioned is completely valid. What matters most is that you and your baby are safe, but your feelings about the experience also matter.
Processing an Emergency C-Section
An emergency cesarean section can be a frightening and disorienting experience, especially when it happens quickly and without time to prepare emotionally. Feelings of shock, grief, relief, guilt, anger, or numbness afterward are all normal. Processing this experience takes time, and support is available.
Related Resources
Frequently asked questions
Is stalled labor (failure to progress) normal?
When should I call the doctor about stalled labor (failure to progress)?
When is stalled labor (failure to progress) normal?
What causes stalled labor (failure to progress)?
What should I mention to my pediatrician about stalled labor (failure to progress)?
Is stalled labor (failure to progress) normal at Labor & delivery?
Is stalled labor (failure to progress) normal at Postpartum?
Should I go to the ER for stalled labor (failure to progress)?
Does stalled labor (failure to progress) go away on its own?
References
- [1]American College of Obstetricians and Gynecologists. Safe Prevention of the Primary Cesarean Delivery. ACOG/SMFM Obstetric Care Consensus No. 1, 2014 (Reaffirmed 2021). ACOG
- [2]National Library of Medicine. Abnormal Labor. StatPearls, 2023. NIH
- [3]National Institute for Health and Care Excellence. Intrapartum Care. NICE CG190, 2023. NICE
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Stalled Labor (Failure to Progress).
Things to mention
- Describe when you first noticed stalled labor (failure to progress) and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if you feel your labor has stalled and want to discuss options.
- Mention if you have been pushing for a long time without progress.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- You feel your labor has stalled and want to discuss options
- You have been pushing for a long time without progress
- You are exhausted and need to discuss your options
Urgent signs to report immediately
- Signs of fetal distress during a prolonged labor (your care team will be monitoring this)
- Fever during labor suggesting possible infection
- You are unable to cope and need immediate support
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members
Related Resources
Bottom line
Most cases of stalled labor (failure to progress) are normal. Talk to your pediatrician if signs of fetal distress during a prolonged labor (your care team will be monitoring this).
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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Questions About Labor Induction
Labor induction is the process of starting labor artificially before it begins on its own. It may be recommended for medical reasons (such as post-dates, preeclampsia, or gestational diabetes) or may be offered electively at 39 weeks or later. Modern induction methods are safe and effective, though the process may take longer than spontaneous labor.
When Birth Does Not Go as Planned
It is very common for birth to unfold differently than planned. About 1 in 3 births in the US involve cesarean delivery, and many other births involve unplanned interventions. Feeling disappointed, sad, or even grieving the birth experience you envisioned is completely valid. What matters most is that you and your baby are safe, but your feelings about the experience also matter.
Processing an Emergency C-Section
An emergency cesarean section can be a frightening and disorienting experience, especially when it happens quickly and without time to prepare emotionally. Feelings of shock, grief, relief, guilt, anger, or numbness afterward are all normal. Processing this experience takes time, and support is available.
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