For more than 60 years, it has been the standard of care to try to speed up childbirth with drugs, or to perform a cesarean section if labor was seen as progressing too slowly.
Now a new set of recommendations is changing the game.
In February, the World Health Organization released a set of 56 recommendations in a report called Intrapartum Care for a Positive Childbirth Experience. One key recommendation is to allow a slow labor to continue without trying to hurry the birth along with drugs or other medical interventions. The paper cites studies showing that a long, slow labor — when the mother and baby are doing well — is not necessarily dangerous.
A little history is required to understand the importance of that one recommendation, says Dr. Aaron Caughey, chair of the Department of Obstetrics and Gynecology at Oregon Health & Science University, who did not work on the report. In 1955, Dr. Emanuel Friedman studied 500 women and concluded that labor is normal when, during the intense phase of contractions, the cervix opens at a rate of at least one centimeter (about 0.4 inches) an hour. “Dr. Friedman showed that 95 percent of women progressed” at this rate, says Caughey. “And that became the standard of care.”