Dystocia

Dystocia means difficult labour or difficult birth. In nursing practice, the term is used in two closely related but clinically different ways. Labour dystocia refers to abnormal or delayed progress of labour, such as slow cervical dilation, poor fetal descent, or arrest of labour. Shoulder dystocia refers to an obstetric emergency in which the fetal head delivers, but the shoulders do not deliver with normal gentle traction because one or both shoulders are impacted. ACOG’s current labour-management guidance includes definitions for first- and second-stage labour arrest and management of dystocia, while shoulder dystocia is treated as a separate acute intrapartum emergency. For the RN, dystocia requires strong clinical judgment because the nurse is often the first person to notice abnormal labour progress, worsening fetal status, ineffective contractions, maternal exhaustion, or early signs of an emergency. The RN does not diagnose dystocia independently, but the RN plays a critical role in assessment, communication, fetal surveillance, maternal support, preparation for interventions, emergency response, documentation, and postpartum monitoring. A key learning point is that dystocia is not always caused by one factor. Labour...