The authors of the NIH study note in the press release that while their study doesn't identify all the factors contributing to longer delivery times, the findings do indicate that current delivery practices may need to be re-evaluated. They suggest that the timeline for when to intervene with pitocin or to order a cesarean should be updated to reflect the current findings.
Dr. Laughon says, "We found a lot of c-sections ordered because of failure to progress. According to our findings many of these occurred before women got into active stage of labor."
She says that women who are motivated to have a natural labor and delivery, can feel more comfortable asking for more time if labor is going slowly.
D. Ware Branch, a Maternal-Fetal Medicine specialist with Intermountain Healthcare, chimed in, "Well-informed women who prefer a natural birth, might want to seek out care givers who are familiar with modern labor pattern that favor vaginal delivery when safe."
Doctors in the early 2000s also administered the hormone oxytocin more frequently (in 31 percent of deliveries, compared with 12 percent in the 1960s), the researchers found. Oxytocin is given to speed up labor, often when contractions seem to have slowed. "Its use should be expected to shorten labor times," Dr. Laughon explained. She continued, "Without it, labor might even be longer in current obstetrics than what we found."
The study compared data from nearly 40,000 deliveries between 1959 and 1966 with records of almost 100,000 deliveries that took place in 2002 through 2008. Data from the recent deliveries were collected through the NICHD-supported Consortium on Safe Labor.
Dr. Laughon conducted the study with D. Ware Branch, M.D., of Intermountain Healthcare and the University of Utah, in Salt Lake City; Jun Zhang, Ph.D., M.D., with the NICHD at the time of the study and now with the Shanghai Jiaotong University School of Medicine, China; and Julie Beaver, M.S., formerly with the NICHD.