How active is our active phase? Laborious Labors

Dr Emmanuel Friedman in 1954 published the first of his landmark papers on labor progress. The 50s were a wonderful time. Women wore poodle skirts, had almost no access to contraception even diaphragms were practically a trade secret, and the baby boom was on. Birthing was charted and we've been patiently plotting women's contractions along a dotted Friedman curve since each obstetrician and midwife has cracked open her (or his) edition of Williams Obstetrics. Active phase of labor was defined around 4 centimeters of dilatation, and progress slower than some dilatation every 2 hours with good uterine contractions has been the C-section bell. Of course that bell only rang about 3-5% of the time. And anesthesia, that was quite different as well it was more than likely to mean ether! But much research has come to question what would be normal for a modern gal. Even waiting 4 hours for a bit of progress, in the appropriate pregnancy with no signs of distress, appears to increase the number of women who will deliver vaginally by a significant margin. So the norms for that active phase are being evaluated and will hopefully lead to more vaginal deliveries for more women!


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