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Modern obstetric interventions (e.g., epidural analgesia, induction) alter the natural progression of labor. Thus, criteria that Friedman developed 50 years ago to characterize labor's progress do not apply to contemporary obstetric practice. To evaluate patterns and duration of spontaneous labor in U.S. women, investigators analyzed data from the Consortium on Safe Labor, a multicenter retrospective observational study, conducted from 2002 to 2008. All 62,415 participants had singleton term pregnancies, vertex presentations, and neonates with normal outcomes.
Some women required >6 hours to progress from 4- to 5-cm cervical dilation and more than 3 hours to progress from 5- to 6-cm dilation. Labor in nulliparous and multiparous women progre…