Abnormal Progress in

Labor
Precipitous Labor and Birth

Retraction Rings
Precipitous
Labor and
Birth
Precipitate Labor – occur when
uterine contractions are so strong that
the woman gives birth with only so
strong that the woman gives birth
with only a few, rapidly occurring
contractions. It is also defined as an
extremely rapid labor that last less
than 3 hours from start to finish
Precipitate Birth - is a sudden and
often unattended birth.
 Contributing
Factors:
•Multiparity
•Large pelvis
•Previous precipitous
labor
•Small fetus in a
favorable position
Signs & Symptoms
• Increased pain more than normal
• Increased maternal heart rate, pulse and body temp
• Increased BP
• Nasal Flaring
• Anxiety
• Restlessness
• Hypertonic Contractions
Maternal risk:
• Lacerations of the cervix, vagina, and or
perineum
• Uterine rupture
• Amniotic fluid embolism
• Postpartal hemorrhage
• Abruptio placentae

Fetal/neonatal risk:
• Fetal hypoxia
• Cerebral trauma
• Meconium stained fluid
• Low apgar score
Nursing
Care Plan
Assessment:
• Assess previous labor history if the woman is a
multipara
• Assess contraction status. Be alert for
contractions that are more frequent than every 2
minutes and dilatation that progresses faster
than normal (more than 1.5cm/hr)
• Assess fetal status
• Assess mothers comfort level
• Assess mother’s coping abilities

Nursing Diagnoses:
• Acute pain related to accelerated labor pattern
• Risk for ineffective coping related to
ineffectiveness of breathing techniques to relieve
Planning:
During the entire process of labor and birth:
• The nurse should closely monitor the woman’s
contractions and cervical dilatation, and an
emergency birth pack is kept near the bedside.
• The nurse should stay in constant attendance,
assist the woman to a comfortable position and
provides a quiet environment.

Nursing Interventions:
Non- Pharmacologic:
• Continue electric monitoring
• Remain in room to provide support and comfort
measures for the woman
• Instruct the woman not to bear down until
she is instructed to do so.
• Instruct woman to pant with contractions if
fetal head is crowning
• Apply gentle pressure anteriorly against
the fetal head to maintain flexion and
prevent it from delivering too quickly.
• Support the perineum by making U shape
with the other hand and supporting the
descending head between contractions to
prevent excess tearing and perineal
lacerations.
Pharmacologic:
• In such cases, a tocolytic agent such as
terbutaline may be administered to reduce
the force and frequency of contractions
• Notify physician for rapid cervical changes

Evaluation:
• The woman and her baby are closely
monitored during labor and a safe birth
occurs
• The woman states that she feels
supported and enhanced comfort during
labor and birth