According to researchers at the National Institute of Health (NIH) the length of labor is two to three hours longer compared to what it was in the 1960s. The added hours come in the first stage of labor– the dilating and effacing stage.
Though moms these days are older, heavier and give birth to larger babies, these factors were apparently not the issue. “But even when we take these changing demographics into account, labor is still longer,” said lead researcher Dr. Katherine Laughon. “We weren’t able to fully address the potential reasons with this study.”
It may be the increase use in epidurals, which are much more common these days and can slow down labor in some situations. According to Laughon an epidural slows labor by 40-90 minutes. It may have something to do with the increase in inductions/reduced spontaneous labors and c-sections in the last 50 years.
Though they can’t pinpoint the cause, Laughon said the take-away is that there’s a new “normal” and we need to adjust our expectations: “I think we need to revisit the definitions of ‘abnormal’ labor, and the timing of the interventions that we use,” she said. If the expectations for how fast labor moves are unrealistic too many labors will be considered “failing to progress” and interventions will be used– such as the induction medication pitocin- when they are actually unnecessary.
I can think of a couple of other reasons labor is longer these days, totally speculating here but it’s an interesting question:
*The use of continuous fetal monitoring.
Fetal monitoring requires that mom be fairly still (usually on her back or side) for either the whole labor or most of it. But labor benefits and can be more efficient when mom is moving around, opening her hips and generally using gravity to bring the baby down. I wonder if moms were able to move around a bit more in the 1960s?
*The hospital environment and support.
Now I can’t really speculate about this too much because in the 1960s there were some barbaric practices in the labor wards including the dreaded Twilight Sleep, an amnesia-inducing drug that knocked women out and sometimes caused hallucinations. But there were also women giving birth without medication, like my own mother. I do know that these days having a doula support you through labor can shave off time, maybe up to a couple of hours in a first time birth. Most women do not have doulas, however, and are instead accompanied by the aforementioned fetal monitor for most of labor. Of course there are labor and delivery nurses and many are excellent but they are neither trained nor staffed to be there continuously during labor. It’s the continuous support that helps moms. We also know that the labor hormone oxytocin does not respond well to fear and bright lights and observation— labor tends to slow down a little when moms get to the hospital, probably for this reason. Maybe in the 1960s there was a bit more of an effort to give women privacy and support?
In the end, I agree with Laughon’s concluding point. The expectations for the speediness of labor– especially in first time moms— is unrealistic and sets us up for “failure to progress.”
Photo Credit: Crimfants/Flickr