Tuesday, May 1, 2012

How Long is Too Long

One of the most commonly voiced concerns these days is, " How can I avoid a cesarean section? ". As the  C-section rate continues to increase exponentially, more and more studies are looking for answers to this prevalent question. One- half of all cesarean sections are performed for "failure to progress" or cephalopelvic disproportion at a point in labor that is early, not even active phase. More than twenty-five percent of first time moms, ( with spontaneous onset of term labor with a head-down fetus ) had a cesarean section at five centimeters or less. With more than fifty percent of induced labors concluded with cesarean section at five centimeters or less.

Labor with midwives and no interventions ( oxytocin, epidurals or instrumental vaginal extractions ) does indeed take longer and the outcome is good.  It is shown in studies that labor overall is longer these days than it used to be and still there are good outcomes with no major medical interventions. Setting the standard as one centimeter per hour as abnormally slow progress ( 6 hours from 4-10 centimeters! ) means medically augmenting first-time mothers' labors faster than the average rate: failure to progress and a cesarean section waiting to happen. Major intervention and the subsequent potential for complications may be incentive for some women to start examining the data and insisting on choice.

I would never suggest that any women go against her providers directives. But I will suggest that individuals do their homework, interview midwives and physicians and know their options before making choices. An average first labor may be sixteen to eighteen hours before the cervix is complete and second stage can take up to three hours, after that. Labor is a process of wellness. Labor is not a disease that must be medically managed It's wonderful to have the medical back-up necessary but it's essential to have the patience to let the body do what it was born to do.