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The definition of “normal” labor progression has changed with the evolution of obstetric practice (NEJM JW Womens Health Dec 16 2010). In a retrospective cohort study at one teaching hospital, researchers derived average curves for cervical dilation and fetal descent in 4618 women (33% nulliparous) with vaginal term deliveries sometime between 2004 and 2008. The study sample was stratified by parity and type of labor (spontaneous vs. induced or augmented).
Multiparous women achieved faster fetal descent than nulliparous women at almost all pelvic stations. Labor was spontaneous in 39% of participants overall. Fetal descent was faster in spontaneous labor than induced or augmented labor even after adjustment for parity, maternal body-mass ind…