There has been a re-evaluation of the timing and progression of labor sort of going on behind the scenes for awhile now. While many have clung to the Friedman curve to measure progress in labor, others had started to investigate the wider range of variations to “normal labor.” These, now decades old studies, by Friedman and his colleagues created the notion of a normal progression of 1cm dilation per hour in the active phase of labor. The idea that active labor begins when a woman is dilated to 4cm has become a mainstay of modern obstetrical practice.
Ask most birth professionals and they’ll tell you that they’d already figured that out, of course! Anyone who has been around enough women in labor knows that it is a process and not one that follows a neat little curve. In fact, as our society and the practice of medicine have tried to place time constraints on the progression of labor and micro-manage laboring women the more we have seen women fail to feel confident and successful in their birth experience. “Stalled labor,” “failure to progress,” “labor dystocia”- the notion that something was wrong with process if a woman didn’t progress 1cm/hr has had a significant impact on the rate of labor augmentation and c-sections.
More contemporary studies are now providing clear evidence that the reality of labor is much different, confirming what many have long suspected. The studies suggest that normal labor can progress at rates that are less than 1cm/hr, especially for women who have not previously given birth. Adding to that, the evidence indicates that many women progress quite slowly before reaching 7cm dilation.
The move to redefine active labor as beginning at 5cm for women who have previously given birth and 6cm for those who have not, is a step in the right direction to say the least. This evidence only adds to what many birth professionals have been telling women all along- TRUST the PROCESS! Believe in your body and your ability to give birth to your baby… not on neatly plotted curve… but rather, when your body and your baby are able to complete the process.
Of course there will always be women who experience difficulties with labor or unavoidable complications and the appropriate interventions can be essential to achieve the best outcome for both mother and baby. There is just no reason to go looking for problems where they do not exist, and this new concept of active labor can go a long way to reduce unnecessary pressure on laboring women.
For more information, check out this article!