Many tasks can be tackled more quickly now
than 50 years ago, but delivering a baby naturally it seems is not one of them,
according to a US government study.
Compared
with the 1960s, US women have in recent years spent two to three hours longer
in labor, according to researchers at the US National Institutes of Health, who
said the findings suggest doctors may need to rethink the definition of
"normal" labor.
The
extra time is spent in the first stage of labor - the longest part of the
process, before the "pushing" stage, according to findings published
in the American Journal of Obstetrics & Gynecology.
Mothers
are different as well. On average, they're older and weigh more, and their
newborns are bigger too.
"But
even when we take these changing demographics into account, labor is still
longer," said lead researcher Katherine Laughon, at the National Institute
of Child Health and Human Development.
Though
Laughon said the study wasn't able to fully address the potential reasons for
the difference, one partial explanation may be epidural pain relief, which is
far more common now than 50 years ago. Epidurals are known to slow labor down
by about 40 to 90 minutes.
The
findings were based on two government studies done decades apart.
One,
between 1959 and 1966, included about 39,500 women who delivered a full-term
baby, while the other tracked more than 98,000 women who had a full-term baby
between 2002 and 2008.
All of
the women had a spontaneous labor - that is, not induced.
When it
came to length of labor, first-time mothers in recent years typically spent 2.6
hours longer in the first stage, compared with their counterparts in the 1960s.
The difference dropped to two hours with women who had given birth before.
Contemporary
women were far more likely to have an epidural - 55 per cent, compared to just
four per cent of counterparts 50 years ago. Twelve per cent had a C-section
compared with three per cent in the 1960s, while 31 per cent were given
oxytocin, which stimulates contractions, against 12 per cent 50 years ago.
Laughon
noted that many more women now have labor inductions or planned cesarean
sections versus decades ago, so women who actually go into spontaneous labor
these days may differ somehow from their counterparts of 50 years ago.
But
whatever the underlying reasons, doctors may need to redefine
"normal" labor, a concept that's based on what was the norm for women
a half-century ago.
For
example, doctors have considered labor to be abnormal if there's no change in
the cervix after two hours in the "active"part of the first stage of
labor. At that point, they may intervene by either giving ocytocin or doing a
C-section.
Laughon
said the bottom line is that there may be a new"normal," adding:
"I think we need to revisit the definitions of'abnormal' labor, and the
timing of the interventions we use."
Reuters
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