Psychological factors impeding the progress of labor: case observations and the need for a multidisciplinary approach.

Abstract

Objective: This report aims to draw attention to the potential role of psychological factors in impaired labor progression and to highlight the potential value of a multidisciplinary approach, including birth psychotherapy.

Methods: We retrospectively reviewed four clinical observations of impaired or arrested labor progression associated with psychological factors without identifiable obstetric pathology. Care involved obstetricians and midwives, with individualized psychological consultation when indicated.

Results: The cases involved negative childbirth conditioning, acute grief, fear of maternal inadequacy, and previous birth trauma. In two cases, labor arrest was followed by emergency cesarean delivery for fetal distress; both women subsequently achieved uncomplicated vaginal births after cesarean following birth psychotherapy. In a third case, labor arrested at 7 cm dilation and resumed after a 30-minute remote psychological consultation, followed by vaginal birth within approximately 30 minutes. The fourth case involved successful vaginal birth after cesarean with antenatal birth psychotherapy and continuous multidisciplinary support.

Conclusion: These observations suggest that psychological distress may contribute to impaired labor progression in selected cases. Individualized psychological support within collaborative obstetric and midwifery care may be beneficial. Given the small, descriptive case series, causal conclusions cannot be drawn.