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Study: Allowing women to extend labor reduces c-sections

The rate of cesarean section deliveries was cut in half when women were allowed to stay in labor for a longer period of time.

By
Stephen Feller
Women in labor who receive an epidural are generally allowed to remain in labor for about three hours, but researchers found waiting up to one more hour significantly reduced the number of c-sections performed by doctors. Photo by Tyler Olson/Shutterstock
Women in labor who receive an epidural are generally allowed to remain in labor for about three hours, but researchers found waiting up to one more hour significantly reduced the number of c-sections performed by doctors. Photo by Tyler Olson/Shutterstock

PHILADELPHIA, March 16 (UPI) -- Allowing women to stay in labor for a longer period of time slashed the chance for cesarean delivery in half, according to a small study.

Researchers at the Thomas Jefferson University found women allowed to remain in labor for up to four hours, rather than the recommended three, gave enough time for the procedure to be unnecessary.

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The standard, since the 1800s, has been to allow a mother to remain in the second stage of labor, full dilation, for two hours before performing a c-section. In the 1980s, the recommendations were updated to allow women given an epidural to stay in labor for three hours.

Previous studies have shown about 10 to 15 percent of births are by c-section, and are expected in situations where the life of a mother or baby is in danger. About 32.2 percent of births in the United States are by c-section.

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In addition to a study that found elective, planned c-sections have doubled in recent years, the World Health Organization cautioned last year that the procedure poses health risks for mothers and should not be overused based on desire or convenience.

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"This was a small study, so a formal change in guidelines should be based on a larger sample of women," Dr. Alexis Gimovsky, a maternal fetal medicine fellow at Thomas Jefferson University, said in a press release. "But this study shows what we have observed in practice -- there is benefit to allowing women to labor longer."

For the study, published in the American Journal of Obstetrics and Gynecology, researchers recruited 78 women who were between 36 weeks and 42 weeks pregnant to be given epidurals and randomly assigned to either a standard labor time of three hours or four hours.

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Among women given three hours, 43.2 percent had c-sections, while just 19.5 percent in the four-hour group had the procedure. The researchers reported there were no significant differences in maternal or neonatal morbidity outcomes.

"For the sake of reducing the number of cesareans that are performed in this country, we should further investigate expanding the time frame," Gimovsky said.

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