Precipitous Labor: Everything You Need to Know

Have you ever read about those birth stories where the parent gives birth in the back of a taxi or on a plane (or some other surprising locale), and they always say, "the baby just came so fast!" That quick labor they experienced is called precipitous labor, and it's super rare, making up around 3% of all births.

While most labors stretch several long hours, some parents experience precipitous labor (or fast labor) that only lasts two or three hours. Fast labor seems great at first glance (fewer contractions and less pain!), but it could actually come with a host of worrisome side effects ranging from emotional trauma to baby head injury. Here’s everything you need to know about the symptoms, causes, and complications of rapid or precipitous labor.

What is Precipitous Labor?

Labor duration depends on factors like the baby’s position, whether you had an epidural, and previous childbirth experience. Typical early stages of labor usually last six to 12 hours for a first-time parent and two to five hours for an experienced mother. Active labor stretches for an additional four to eight hours on average when your cervix dilates, and contractions get stronger, although the length of active labor can vary greatly.

Rapid or precipitous labor doesn’t follow this typical timeline. “Precipitous labor is when the duration of labor is two or three hours,” says Dr. Iffath Hoskins, M.D., maternal-fetal medicine specialist at NYU Langone Health. “In precipitous labor, the patient’s cervix rapidly dilates from a lesser dilation (like two or three centimeters) to fully dilated.”

What Causes Precipitous Labor?

There are no concrete risk factors for having precipitous labor. But “if a woman has had lots of children, they are at risk for delivering more quickly,” according to David F. Colombo, M.D., medical director for obstetrics at Spectrum Health Medical Group in Grand Rapids, Michigan. Also, those with a history of precipitous labor are more likely to experience it again.

No one knows for certain why some pregnant people will experience precipitous labor, but some studies suggest that certain health conditions may contribute to its occurrence. For example, according to the European Journal of Obstetrics & Gynecology and Reproductive Biology, the following health condition may increase the risk of precipitous labor:

• Placental abruption
• Fertility treatments
• Chronic hypertension
• Intrauterine growth restriction
• Induction with prostaglandins
• Low birth weight

Precipitous Labor Symptoms

With precipitous labor, symptoms come on suddenly and intensely. You may feel several contractions that occur back-to-back. Some people experience a singular, continuous contraction or abrupt pressure. Either way, the rapid cervix dilation may cause pain and the urge to push, says Dr. Hoskins.

Typical labor contractions will build up over time. They will start short and feel similar menstrual cramps and gradually grow stronger and last longer. Precipitous labor contractions don't have a break in between and feel intense from the beginning, including an urge to bear down and push.

Complications of Precipitous Labor and Delivery

Some people view precipitous births as a good thing, says Dr. Colombo. “People enjoy delivering their child more quickly,” he explains. They won’t need to spend hours enduring the symptoms of labor – including painful contractions that usually last throughout the active phase. However, precipitous labor and delivery often come with unpleasant side effects.

For example, a birthing parent may tear their vagina or perineum due to the rapid birth, says Dr. Hoskins. The uterus or vagina may also hemorrhage. Additionally, if doctors have to rush and “catch” the baby, the precipitate delivery might not be completely sterile.

“There are known risks to the baby, like injury on the head or brain, due to the rapid descent through the mother’s soft and bony tissues,” adds Dr. Hoskins. Specifically, the pressure change could cause intracranial hemorrhage, and the baby could aspire amniotic fluid, which means they could breathe it in.

Shoulder dystocia, which happens when the shoulder gets caught in the mother’s pelvis, can also happen. And once the baby is delivered, “they may have a slower transition to outside life as shown by mild, transient respiratory difficulty,” says Dr. Hoskins. Because the parent is so unprepared for labor and birth, they might suffer shock, depression, or other emotional turmoil after rapid labor.

Getting to the Hospital

Precipitous labor is especially worrisome if the birthing parent lives far from the hospital, since there’s a chance of delivering en route. Also, when they finally arrive at the hospital, labor may have progressed too much for pain medications, making an epidural out of the question.

If you live many miles away from the nearest hospital, Dr. Colombo suggests discussing your due date and birthing plan with your healthcare provider. Your doctor may suggest coming to the hospital earlier than the average person, taking childbirth classes, and preparing for the potential for a home birth.

Dr. Colombo also advises against scheduling an early induction. “People might want to be induced early to ensure they’re in the hospital, but induction before 39 weeks may cause issues,” he says. Waiting to term lessens your baby’s risk of respiratory problems and improper brain development, among other things.