Delayed+Parturition

==**Definition:** == Onset of labor after 42 weeks of gestation; or lack of progress in a labor already initiated
 * IBIS:**

==**Etiology:** == The diagnosis is uncertain since the calculation for the expected date of the mother is not guaranteed to be correct. Accurate dating during the pregnancy is a help, especially the dates of the length of the mother's menstrual cycle, as with a long cycle the delivery date may be late by definition, although the fetus will be appearing at term.

Another type of delayed parturition is when the women has begun to give birth to her baby but the process of labor stops at some point and does not appear to be progressing. Reasons that might exist for a stalled labor include: • Tension, fear and anxiety in the women. • Rigid os: The soft cervix is rigid at the opening or the os does not continue to dilate. • Exhaustion. • Pain. • Cephalopelvic disproportion


==**Nutrition:** == therapeutic foods: • foods that invigorate the Qi, Descending foods, 0utward-moving foods, foods that soothe the Liver

==**Botanicals** == • Aralia racemosa: sipping a root infusion is useful in relaxing a hard cervix (Weed, p. 66) • Asarum canadense: increases energy to help with prolonged labor; do not use too close to delivery since increased circulation may cause hemorrhage (Weed, pp. 66-67) • Caulophyllum thalictroides (toxic): 10 drops tincture under the tongue can soften the cervix in 3-4 hours, continue until cervix is fully ripe; internally as an enema to begin labor or 10-20 drops of tincture to promote a stalled labor. (Weed, pp. 59-60, 65) • Cimicifuga racemosa: to establish regular contractions: 5-10 drops in warm water; repeat hourly for 3-4 hours. If no effect seen after 4 hours, increase to one dropperful an hour for 4 more hours to initiate strong contractions. (Weed, p. 61) • Gossypium herbaceum (toxic): strengthens contractions when labor is erratic or woman tires (Weed, p. 64) • Lobelia inflata (toxic): powerful antispasmodic, vaginal, cervical or perineal rigidity. Use 30-60 drops tincture in water and repeat every 30 minutes, as effects are transitory. Labor is not likely to occur while using Lobelia as uterus will be relaxed, however cervix may ripen allowing labor to occur in near future. (Weed, p. 66; Stansbury) • Oenothera biennis: 3 cap. of oil per day for 1 week may soften the cervix (Weed, p. 59) • Ricinus communis (oil): gently massage into belly, castor oil can stimulate uterus. Several oz. in orange juice may be drunk and followed by a hot shower. Rest, then repeat twice more. The peristaltic action of smooth muscles is stimulated and labor may follow 3-5 hours after last dose (Weed, p. 60) • Senecio aureus (toxic): 10-15 drops tincture in water every 30 minutes for several hours can speed a slowly progressing or halted labor (Weed, p. 64) • Trillium spp. (toxic): roots of the white flowered spp. can both initiate and strengthen contractions. quarter-half tsp. tincture twice, 30 minutes apart. Be aware that salivation and watery eyes are possible side-effects (Weed, p. 64)

==**Chinese Formulae** == • Magnolia and Ginger F. (Ping Wei San): to induce labor (Hsu, 1980, p. 212; Yeung, p. 163; Bensky and Barolet, p. 181)

==**Acupuncture** == after assessing the person and palpating, consider these patterns: Qi Xu (Deficiency); Xue Xu (Blood Deficiency); Xue Yu (Blood Stasis)

» therapeutic note: "Initiation of labor should not be performed out of convenience since this traumatizes the Triple Heater by forcing it to operate before it is ready" (Flaws, 1983, p. 45)

» illustrative combinations: see also: labor pains • St-30 (+), GB-34 (+), CV-3 (+) and then Sp-6 (-) to treat atony of the uterus (Flaws, 1983, p. 45) • LI-4 and Sp-6, with GB-21 and UB-67 or GV-1 and Sp-9 to initiate labor past due date, esp. in a "fat and atonic woman" (Flaws, 1983, p. 45) • CV-4, UB-32, LI-4, St-36 and Sp-6 prior to labor to induce labor (Shanghai, p. 677) • GB-21, LI-4, St-36, LV-3, UB-60 and UB-67 during labor to induce labor (Shanghai, p. 677) • Sp-6, Lv-3, UB-31 and LI-4 (+), but first try finger pressure on Sp-6 and LI-4, "to speed the first stage of labor if it is slow getting started or has slowed down" (Flaws, 1983, p. 45) • UB-67 and St-36: will hasten delivery (Ellis, et al, 1988, p. 236) • Sp-6, LI-4, Lv-3, UB-60 and UB-67 with strong stimulation for inducing labor (Shanghai, p. 677) • UB-31, UB-32, UB-33, UB-34, LI-4 and Sp-6 for inducing labor (Shanghai, p. 217) • GV-1, LI-4, Sp-9 and Sp-6 for inducing labor (Shanghai, p. 216) • St-36, Sp-6, Kd-7 and UB-67 for delayed parturition due to Xu (Deficiency) of Qi and Xue (Blood); can also add: CV-4 (D) and GV-4 (D) for lassitude; PC-6 and Kd-3 for palpitations and shortness of breath (Qiu and Su, p. 20-21) • LI-4, PC-6, PC-6, GB-21, Lv-3 and UB-67 for delayed parturition due to Qi Stagnation and Xue Yu (Blood Stasis) (Qiu and Su, p. 20-21) • LI-4, St-30 and Sp-15; Sp-6, UB-67 and GV-2; UB-23 and UB-33 for prolonged labor (Mann, p. 151) • LI-4 and Sp-6 (can also add: GB-21 and UB-67) for prolonged labor after "liking for leisure, no physical work, (and) excessive sleeping and resting cause Qi and blood to become obstructed" (Mann, p. 151) • LI-4 with St-36 or Sp-6 (one minute strong stimulation to each point after obtaining the Qi) to induce labor when the cervix dilates slowly and/or contractions are weak (Shanghai, p. 677) • (1) three cones, green bean size, of moxa directly to GV-20; (2) LI-4; (3) Sp-6, Lv-1 and UB-60; (4) St-25 and CV-4; seven cones, one-half rice grain size, of moxa directly to tu yin and UB-67 (d. D) to facilitate difficult labor (So, 1987, p. 267) • PC-6 and Kd-3 (+): "resolve palpitations and dyspnea" (Qiu and Su, p. 21) • PC-6 and GB-21 (-): "relieve distention and fullness of chest and hypochondrium" (Qiu and Su, p. 21) • LI-4 (++) and Sp-6 (+): promote smooth Qi and Xue (Blood) circulation

==**Homeopathy** == • Aconitum napellus: tedious and difficult labor; violent after pains; shooting; tearing after pains with febrile conditions • Arnica montana: feeling as if fetus lying sideways; soreness; tenderness; sensitive to motion of fetus; sore and bruised; dribbling of urine after labor • Calcarea fluorica: marked flatulence during pregnancy; often pains from feeble contractions • Cinchona: womb troubles in general • Collinsonia: with bad hemorrhoids • Gelsemium: spasmodic labor pains; rigid os; inefficient labor pains or none at all • Lac Humanum: history of difficult mother-daughter relationship; issues of nourishment

==**Subtle Support** == • notes: A, A#, B, C, C#, D, E, F, G, G#

• chords: A minor, C minor, D minor, D# minor, tonic (Gimbel, p. 116)


==**Mind/Body** == • All problems that delay childbirth or make it difficult are ultimately signs of an attempt to hang onto the child. The same issues may arise later in life between mother and child when the child wants to leave the parental home. The whole of human life alternates between the two poles of 'letting in' and 'letting go'. (Dethlefsen, p. 189)

Chinese psychophysiology: • Liver ~ Gan is the home of the Hun (Ethereal Soul); it relates to decisiveness, control, and the principle of emergence; maintains smooth flow of Qi and Xue (Blood); controls the muscles, especially their contractility; has an intimate relationship with the genitals and Lower Warmer; and reflects emotional harmony and movement. » Healthy expressions are kindness, spontaneity, and ease of movement. » Liver Xu (Deficiency) signs include impotence; frigidity; pain in thighs, pelvic region, and throat; ready tendency to "the blahs" (Seem, p. 28); timidity; depression; irritability; vertigo; pruritus; dry skin and/or tendons; asthma; aching at the waist; hernia; and difficulty raising head up and down. Xue Xu (Blood Deficiency) is often derived from the Liver. » Qi Stagnation contributes to Xue Yu (Blood Stasis). Liver Qi Stagnation reflects and accentuates emotional constraint as the Liver's function of facilitating smooth flow in the body is constricted. Stagnation is associated with frustration, irritability, tension, and feeling stuck. With time this pattern tends to produce a gloomy emotional state of constant resentment, repressed anger or depression, along with tightness in the chest, frequent sighing, abdominal tension or distension, and/or a feeling of a lump in the throat with difficulty in swallowing. (Maciocia, p. 216)

• Spleen ~ Pi governs digestion and manifests in the muscle tissues; transforms food into Qi and Xue (Blood); governs the Xue (Blood) and holds it in the vessels; resolves Dampness and Phlegm; and relates to the ability to assimilate, stabilize, and feel centered and balanced. » Healthy expressions are fairness, openness, deep thinking, and reminiscence. » Spleen Xu (Deficiency) signs include slightness (deficient "form"); abundant elimination; morning fatigue; cold, wet feet (Seem, p. 28); abdomen taut and distended like a drum; craving for sweets; flatulence; nausea; mild edema; memory failure; heavy feeling in legs; easy bruising; pale lips; loose stools; muscular weakness; and, indirectly, obesity. » The excessive use of the mind in thinking, studying, concentrating, and memorizing over a long period of time tends to weaken the Spleen and may lead to Xue Yu (Blood Stasis). This also includes excessive pensiveness and constant brooding. (Maciocia, p. 241) Likewise, inadequate physical exercise and excess consumption of sweet and/or Cold foods will also deplete the Spleen. Environmentally, the Spleen is highly susceptible to attack from external Dampness and Cold.

• Kidney ~ Shen stores Jing (Essence) and governs birth, growth, reproduction, development, and aging, particularly the internal aspects of the reproductive organs; houses the Zhi (Will); and expresses ambition and focus. » Healthy expressions are gentleness, groundedness, and endurance. » Kidney Xu (Deficiency) signs include indecisiveness; confused speech; dreams of trees submerged under water; cold feet and legs; abundant sweating (Seem, p. 28); hearing loss; fearfulness; apathy; discouragement, and scatteredness » Intense or prolonged fear depletes the Kidney. Often chronic anxiety may induce Xu (Deficiency) and then Fire within the Kidney. (Maciocia, p. 250) Overwork, parenting, simple aging, and a sedentary or excessively indulgent lifestyle all contribute significantly to Kidney Xu (Deficiency).