The Six Ways to Progress in Labor
By Penny Simkin, PT

1. The position of the cervix changes (from posterior to anterior).
 
2. The cervix ripens (softens).
 
3. The cervix effaces (thins).
 
4. The cervix dilates (opens).
 
5. The fetal head rotates and molds.
 
6. The fetus descends.

Usually the first four steps are well underway before a woman experiences the positive signs of labor. Occasionally, however, a woman begins having strong labor contractions before significant changes have taken place in the cervix. If so, she will probably have a Slow-to-Start Labor, and will need help in pacing herself and accepting the slow progress.

There is no reason to believe there is anything wrong with such labor. The woman simply needs more time and more contractions to bring about the early changes in the cervix.

The chances are that when her cervix is ready, the labor will speed up and progress normally.

The greatest challenge will be in accepting the slow pace without becoming discouraged. She and her loved ones will need reassurance from optimistic support people and caregivers, along with distracting actvities, nurturing, and rest.