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Early-stage labor lasts longer today than 50 years ago, and the data suggest that the current clinical approach to labor and delivery are the reason for it.
Compared with 50 years ago, first-stage labor is 2.6 hours longer in nulliparas and 2 times longer in multiparas.
The authors cite the use of epidurals and the current approach to labor as factors in longer birthing time.
Delivering a baby takes longer now than it did 50 years ago, calling into question the benefit of modern-day interventions, according to a recent study from the National Institutes of Health.
Using 2 United States government studies, researchers compared data from almost 40,000 women who spontaneously delivered cephalic singleton fetuses between 1959 and 1966 and from almost 100,000 similar women who delivered between 2002 and 2008.
Published online March 12 in the American Journal of Obstetrics and Gynecology, the study revealed that the first stage of labor for 21st century women was longer by a median of 2.6 hours in first-time mothers and 2.0 hours in multiparas, suggesting that the increase is largely because of changes in the medical approach to labor.
Compared with 20th century women, modern women are, on average, almost 3 years older; almost 4 kg/m2 heavier; are more likely to receive epidurals (55% vs 4%), oxytocin (31% vs 12%), and undergo cesarean delivery (12% vs 3%); and they are more likely to have bigger babies. But even after adjusting for these factors, labor was still longer among 21st century women.
The authors surmise that the increased length of labor is at least partially due to the increased use of epidurals. They recommend reexamining current definitions of normal and abnormal labor and considering whether to redefine when and how clinicians intervene in the birth process.
Read other articles in this issue of Special Delivery