Potential Pitfalls of Prolonged Second Stage of Labor

Establishing the rates of maternal or neonatal risks associated with prolonged second stage of labor can inform decisions about continuing to labor with the goal of achieving vaginal birth. In a retrospective cohort study, investigators analyzed medical records from singleton births at ≥36 weeks' gestation in 43,810 nulliparous women and 59,605 multiparous women. Prolonged second stage was defined (based on guidelines of the American College of Obstetricians and Gynecologists) as >3 hours or >2 hours in nulliparous women, or >2 hours or >1 hour in multiparous women with or without epidural anesthesia, respectively.

Prolonged second stage occurred in 10% to 14% of nulliparous women and 3% to 6% of multiparous women. Among nulliparous women, v…