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What Causes Lack Of Labor Pain Even After Due Date?

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Posted on Thu, 9 Apr 2015
Question: Hi Doctor, my wife is pregnant and was having due date on 17 March, 2015. Her last period starts on 10th XXXXXXX 2014.
Till now 20 March she didn't got any pain started. Now the doctor is saying that we have to do surgery to get the child out. Her pelvic mouth didn't open up and have no chance for normal delivery. Please guide me what to do.
Thanks XXXXXXX
doctor
Answered by Dr. Nidhi Setia (1 hour later)
Brief Answer:
induction of labour.

Detailed Answer:
Hello Mr. XXXXXXX
Welcome to HCM.

I can understand your concerns.

In clinical practice, we usually wait for one week after expected date of delivery for labor pains to start. Provided the common risk factors like hypertension, diabetes, inadequate liquor, breech presentation are not present.

In case of your wife, if there are no risk mentioned above, I would suggest that you should wait for another 3-4 days for labour pain to start.
If the pain does not even after that, a trial of induction of labour is given using drugs like prostaglandins and other methods.

If induction fails, then we can proceed for surgery (cesarean section).

Discuss these issues with your treating doctor. This will help you to decide the best course of action for you wife in conjunction with your treating doctor.

Hope this helps.

Fee free to discuss further.

Take care.
Thanks.
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Nidhi Setia (3 hours later)
Thanks for the concern.
All test are normal. Doctor is saying that child's head is not touching the part from where it has to come out. It is hanging away from it. In this case if we induce labour then also child will not deliver normally . Head has come down but it has not touched the delivery path.
doctor
Answered by Dr. Nidhi Setia (8 hours later)
Brief Answer:
Probable cephalo-pelvic disproportion.

Detailed Answer:
Hello again.

Sorry for the delayed response.

Since your wife has crossed expected date of delivery and head has not touched the delivery path (as you mentioned), this suggests that the head is not engaged. The probable reason for this could be cephalo-pelvic disproportion (CPD).

However, in this case also, there is no harm in giving a trial of normal delivery by induction. If there is no progress, then cesarean must be done.

But, the judgement varies from clinician to clinician.

You can discuss this with your doctor. If he/she feels that there is urgent need for cesarean, then you should trust his/her clinical acumen and follow accordingly. Because he/she is the one who is seeing the patient face to face.

Hope this helps.

I wish good health for you and your wife.

Take care.
Thanks.
Above answer was peer-reviewed by : Dr. Pradeep Vitta
doctor
Answered by
Dr.
Dr. Nidhi Setia

OBGYN

Practicing since :2009

Answered : 761 Questions

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What Causes Lack Of Labor Pain Even After Due Date?

Brief Answer: induction of labour. Detailed Answer: Hello Mr. XXXXXXX Welcome to HCM. I can understand your concerns. In clinical practice, we usually wait for one week after expected date of delivery for labor pains to start. Provided the common risk factors like hypertension, diabetes, inadequate liquor, breech presentation are not present. In case of your wife, if there are no risk mentioned above, I would suggest that you should wait for another 3-4 days for labour pain to start. If the pain does not even after that, a trial of induction of labour is given using drugs like prostaglandins and other methods. If induction fails, then we can proceed for surgery (cesarean section). Discuss these issues with your treating doctor. This will help you to decide the best course of action for you wife in conjunction with your treating doctor. Hope this helps. Fee free to discuss further. Take care. Thanks.