Obstructed labour (aka labour dystocia) is when, even though the uterus is contracting normally, the baby doesn't exit the pelvis during childbirth, due to being physically blocked.

• Large or abnomally positioned baby, including shoulder dystocia (i.e. where the anterior shoulder doesn't pass easily below the pubic bone)
• Small pelvis, of which risk factors for a small pelvis include:
  • Malnutrition
  • Lack of exposure to sunlight, causing vitamin D deficiency
  • More common in adolescence, as the pelvis may not have finished growing
• Problems w/ birth canal, including narrow vagina and perineum, which may be due to female genital mutilation or tumors

• Partograph, to track labour progression and Dx problems

• C-section
• Vacuum extraction
• Possible symphysiotomy (surgical opening of the pubic symphysis)
• Keeping the woman hydrated
• Antibiotics, if the membranes have been ruptured for >18 hours

• Results in "prolonged labour" (i.e. active phase of labour >12 hours)
• Complications for the baby include not getting enough oxygen, which may result in death
• Increases the risk of:
  • Mother getting infection
  • Mother having uterine rupture
  • Mother having post-partum bleeding
• Long term complications for the mother include obstetrical fistula

• Obstructed labour affects 3.5% of deliveries
• It results in 19k deaths per annum
• Most deaths occur in the developin world

• Shoulder dystocia