Natural Alignment Plateau

The N.A.P. is a normal period of time in many labors when dilation of the cervix is not increasing but uterine activity continues.

The Natural Alignment Plateau is one example of what many women commonly do.  A woman will be in labor and seems to be “progressing” just fine, and then “stall” out around a 5 (average, a 5- can be any number though) and stay a 5 for hours. This is OFTEN when a doctor or nursing staff will tell the mother that she is experiencing “failure to progress” and want to start her on Pitocin, or they may not even state that its Pitocin that they want to put her one, but instead just tell the mother that they are going to give her “a little something to speed things up”.  Once Pitocin is introduced a whole spectrum of things can go wrong.  The most common progression of labor when a woman is experiencing the N.A.P. is she will seemingly stall out at a specific number for a period of time, an hour, many hours- it varies.  However, what usually happens with the N.A.P. is a rapid dilation at the end.  An average of 20 minutes from whatever number you were “stalled” at to completely dilated, is what often occurs in women who are experiencing the Natural Alignment Plateau.

“Failure to progress” in labor is a common reason for unplanned C-sections. Sometimes, though, it might simply be failure to wait.

There are many ways to evaluate the progress of labor, which include: dilation, effacement, station, strength of contractions, time between contractions, duration of contraction, behavior changes, loss of modesty, emotional signs, etc. None of these methods of evaluation are completely reliable on their own, but if they are used together, the coach can get some idea of where they are in labor.


Medical personnel deal mostly with dilation, effacement, and station. They also deal mostly with medicated mothers. They are used to managing labors rather than allowing them to follow their natural course. They like to see a regular pattern of progress in regards to dilation. But it is not uncommon for a mother to reach a point where labor continues, but dilation of the cervix stops for a time.


During this time there are many things that may be happening that are necessary for the birth process to take place. Some of these things include:

1.       Physical alignment of the baby’s presenting part in relation to the mother’s pelvis. This is something we cannot determine; the baby must find the best way through this narrow passage.

2.       Softening of the cartilage in the pelvis and increasing flexibility of the ligaments and tendons as the mother’s body prepares to accommodate the baby.

3.       Time for breasts to form all the immunities necessary to protect the baby after birth.  Secretion from the breasts prior to the onset of labor are very low in these immunities, yet they are full of them by the time the baby is born- this may require some extra time.

4.       The baby may be in need of more contractions which massage the baby, stimulate its nervous and prepare it’s lungs for breathing on the outside.

5.       Psychological changes in the mother:  Adjust to taking on responsibility of another life; anxiety at baby’s first step toward independence; environment where they feel safe and secure.

6.       Psychological changes in baby. (Evidence tends to support that the baby may be going through psychological and emotional changes during this time.)


Something that ALL women walking in the door for their births need to know, is that the ‘numbers of progression’ are simply a guessing game and are not a predication.  Your body knows best when it comes to laboring.  Understanding that our bodies do what they do for a reason, and interfering with our body due to misguided education, or understanding, can actually take what was meant to be an amazing and life giving experience and turn it into a spiral of intervention that leaves you feeling disappointed.



Oly Pen

Natural Childbirth Education



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