Hearing the words “labor isn’t progressing” can be stressful for both birthing families and doulas. A labor stall—sometimes labeled as failure to progress—is one of the most common concerns during childbirth and a frequent reason interventions are introduced.
As doulas, we play an important role when labor stalls. Not by directing medical care, but by supporting physiology, communication, and informed decision-making. And we do this while staying clearly within scope of practice.
Understanding Normal Labor Variations
Labor does not follow a straight line. Progress can speed up, slow down, pause, and restart. This is often without anything being “wrong.”
Normal variations include:
- Long early labor phases
- Rest periods between active phases
- Slower dilation during emotional or environmental stress
- Changes in contraction patterns as baby rotates or descends
Understanding that labor is dynamic helps us normalize the experience and reduce unnecessary fear when progress appears to slow. Prenatal education about this with parents can preemptively support families should they experience a labor stall.
Comfort Measures That Support A Labor Stall
As doulas, we do not diagnose or treat a labor stall and why it is happening. However, we are uniquely positioned to provide comfort measures that encourage physiologic labor progress.
Common supportive strategies include:
- Position changes (upright positions, side-lying, hands-and-knees)
- Movement such as walking, swaying, or stair climbing
- Counter-pressure or hip squeezes
- Water therapy (shower or tub, when available)
- Breathing, relaxation, and reassurance
These measures support comfort, pelvic mobility, and hormonal flow—factors that can influence how labor unfolds. And sometimes, we just need to give families space and time.
Protecting Informed Consent During a Labor Stall
When labor is labeled as “stalled,” decisions may feel rushed or framed as inevitable. This is a critical moment for informed consent.
We can support parents by:
- Encouraging questions about benefits, risks, and alternatives
- Helping them ask if the situation is urgent or time-sensitive
- Reminding families that consent is ongoing
- Supporting the option of time, when it is medically appropriate
This role is about protecting understanding, not influencing outcomes. Our role is not to encourage families to make specific decisions about birth. Our role is to ensure they know their options and their right to informed consent.
Collaborating Respectfully With the Medical Team
Effective doula support includes collaboration—not opposition. Respectful communication helps maintain trust and supports the parent’s experience.
Doulas collaborate by:
- Using calm, neutral language
- Deferring medical questions to providers
- Supporting provider-client communication
- Maintaining professionalism even in tense moments
A collaborative approach strengthens the care environment and helps everyone remain focused on safety and respect.
Staying Within Scope While Advocating
Advocacy does not mean giving medical advice or challenging providers. Ethical doula advocacy centers on presence, information, and empowerment.
Doulas stay within scope by:
- Avoiding recommendations for or against interventions
- Refraining from interpreting medical data
- Supporting client-led questions and decisions
- Centering the client’s voice at all times
This balance protects the doula’s professional role while still offering meaningful support. Our role is never to speak for the parents. We are never to give direct medical advice. We advocate for families by helping them find and use their voices in self-advocacy. Being active participants in the decision-making process is vital for an empowered birth experience.
Why Doula Support Matters When Labor Slows
Research consistently shows that continuous labor support improves birth experiences and can influence how labor progresses. Doulas do not “fix” stalled labor—but our presence, comfort measures, and advocacy can make a difference in how families navigate these moments.
When families feel supported, informed, and respected, they are better equipped to move forward—regardless of how labor ultimately unfolds.
Author: Aliza Juliette Bancoff
Aliza Juliette Bancoff is a well-known doula and doula trainer who has been providing doula services to families for over a decade. She is the founder of Main Line Doulas, a doula group providing doula support in the great Philadelphia area for the last decade, the International Doula Institute, which provides online doula training and lactation training and certification programs and the International Breastfeeding Institute which provides lactation training and certification. She is the co-founder of United Birth, a company devoted to increasing access to doulas across the country to make the perinatal time safer both physically and emotionally. “Every birthing person deserves access to quality doula support. And we are working to make that a reality across the country. The work we are doing to get doulas to every birthing person will decrease the black infant and maternal mortality rate significantly by 2030.” Says Bancoff. Aliza is known for her compassionate and empowering approach to doula work, and she has been featured in numerous media outlets, including United Nations Maternal Health Report, Parent Magazine, CafeMom, theBump and many more. Aliza's journey into doula work began when she gave birth to her first child and felt a strong calling...