Despite the hundreds of stories we have covered where moms give birth quickly in cabs, front laws, boats, bathrooms and on airplanes, a new study reveals that labour(and childbirth) takes much longer than previously thought.
During labor, the cervix dilates or opens, to allow for a baby’s birth. For decades, medical staff has gone by the rule that the cervix should dilate by at least 1 centimeter per hour. A new study, conducted in two African countries found a slower rate of dilation for many women who went on to have healthy, vaginal births.
In the report, which appears online January 16 in PLOS Medicine, researchers noted that often some doctors still wrongly classify slower labor as abnormal which leads to unnecessary, potentially risky interventions such as cesarean delivery.
“It takes repetitive studies and consistent findings to change long-held beliefs,” says Aaron Caughey, a maternal-fetal specialist at Oregon Health & Science University in Portland, who was not involved in the study. “Clinicians need to understand there is great variability in labor length.”
Olufemi Oladapo, a medical officer in the department of reproductive health and research at the World Health Organization, and colleagues gathered data on more than 5,500 laboring women admitted to 13 hospitals in Nigeria and Uganda. All of the women had gone into labor naturally, had been pregnant with single babies positioned head-first, and had healthy, vaginal births.
For both first-time mothers and those who had given birth previously, it often took longer than one hour for the cervix to dilate by 1 centimeter. This pace was slower than expected until the cervix had expanded to 5 centimeters, after which it progressed more quickly. From there, individual labor times varied with some first-time mothers expanding from 4 to 5 centimeters within two hours, and others taking up to seven hours.
“There are several aspects to labor progression, and cervical dilation is just one of them,” says Oladapo. As long as the vital signs of the mother and baby are fine and the baby’s head is descending, a dilation rate of less than 1 centimeter per hour is not a sufficient reason to intervene, he says. Instead, clinicians should support the laboring woman by providing food, drink, pain relief and the freedom to move and find a position in which she is comfortable, he says.
Last year a study published in the March issue of the American Journal of Obstetrics and Gynecology found that when women were given an extra hour to push in the second stage of labor, c-section rates went down by roughly 50%. 43.2% of the women given the typical three hours to push ended up delivering via c-section, as compared to just 19.5% of the women who were given an extra hour to labor.
