According to a new study, allowing a woman to extend the amount of time she's in labor might have better outcomes than current guidelines suggest.
If recent a recent study is any indication, letting a woman remain in labor for longer than the current guidelines allow might have positive outcomes.
According to researchers from Thomas Jefferson University, giving women more time to stay in labor than current guidelines suggest could reduce her risk of having a C-section by 55 percent. The study, which appears in the American Journal of Obstetrics and Gynecology, is reportedly the first to examine what happens when women in the second stage of labor—which comes when they're fully dilated—are given four hours as opposed to three to deliver.
How long is too long?
Current guidelines do offer some flexibility and the amount of time a woman remains in labor is actually at her obstetrician's discretion. With that being said, many physicians use the guidelines, which suggest imposing a "two-hour rule" (which is stretched to three hours for women who have had an epidural) for the second stage of labor.
It's worth noting that this guideline has been around since the 1800s. The researchers argue that it might be time to revisit this policy—according to their findings, extending the time limit of that second stage of labor not only showed a reduction in C-section risk, it also appeared to have no negative health consequences for mothers or their children.
Time to trash the timeframe?
"For the sake of reducing the number of cesareans that are performed in this country, we should further investigate expanding the timeframe," Alexis C. Gimovsky, M.D., a maternal fetal medicine fellow and the study's lead author, said. The study points out that about 30 percent of births in the United States are C-sections, which can put women at increased risk of post-birth complications, affect fetal health and drive up cost of care. According to the researchers, 10-15 percent of those C-sections happen because of that two (or three) hour rule.
Dr. Gimovsky and study senior author, Vincenzo Berghella, M.D., studied 78 first-time mothers between 36 and 41 weeks gestation. The women were randomly split into two groups—one for "extended" labor, another for "usual" labor. All the women opted for an epidural and nearly half of the women had induced labors.
The group of women who had extended labors had a C-section rate of 19.5 percent, while 43 percent of the women in the other group ended up having C-sections.
Dr. Gimovsky stated that almost all the women studied expressed interest in delivering vaginally. "Changing the guidelines may help many women reach that goal," she said.