In the 1950s, an obstetrician named Samuel Greene introduced the concept of “The Greene Curve,” which illustrated a standard timeline for childbirth. He categorized labor into stages and set expectations for how long each stage should last. Among these was the widely accepted guideline of “one centimeter per hour” for cervical dilation. This approach continues to be taught in medical schools and utilized by many practitioners, as highlighted in a recent article on HuffPost. Most expectant mothers have likely encountered this concept in their childbirth classes.
However, my own experience was quite different from Greene’s timeline. Although I was fortunate to have two healthy vaginal births, my body operated on its own schedule, taking its time to dilate in the early hours of labor. Then, without warning, I would speed through the final stages in a frenzied rush just before welcoming my babies into the world.
Every woman’s body is unique, and it’s absurd to think that labor must conform to a one-size-fits-all model. Many of us know women who, despite having healthy babies and no complications, were pressured into unnecessary medical interventions simply because they weren’t progressing according to the “one centimeter per hour” guideline.
Fortunately, in 2018, a groundbreaking study emerged that challenges Greene’s rigid labor rules. Published in the January issue of PLOS Medicine, this research found that labor can progress at various rates among different women and still remain healthy. Notably, it showed that dilation often occurs at a much slower pace than previously assumed.
Conducted by medical officer Grace Thompson at the World Health Organization, the study analyzed the births of 5,550 women from 13 hospitals in Nigeria and Uganda. All participants had normal, low-risk pregnancies and entered labor naturally. Their babies were positioned head-first and delivered vaginally.
When examining the dilation progress of these mothers, researchers discovered that, on average, it took over an hour for them to dilate one centimeter. Dilation typically remained slow until reaching five centimeters, at which point the pace accelerated. Of course, the duration of labor varied significantly, with some first-time moms reaching five centimeters in just a few hours while others took much longer.
Surprising? Not really. Women’s bodies are not machines; we each have our unique rhythm. Yet it seems a study was needed to validate what women have known for ages. “Cervical dilation progression during active labor is not linear,” Thompson remarked in her interview with HuffPost. “The rate of progress varies among women, and they tend to enter their natural acceleration phase at different times.”
Thank you, Grace!
Thompson emphasized that dilation time is not the most crucial indicator of whether labor is progressing well. As long as both the mother and baby’s vital signs remain healthy and the baby’s head is descending, there should be no reason for intervention.
This study is pivotal as it empowers women with greater control over their bodies and birthing experiences. If adopted in practice, it could help reduce the number of unnecessary interventions, particularly C-sections. The American College of Obstetricians and Gynecologists (ACOG) notes that one in three births now results in a C-section, a figure that has risen over the past 15 years. “Slow labor” is often cited as the leading cause for C-sections among first-time mothers. While C-sections can be lifesaving when necessary, the increasing rates raise concerns.
Fortunately, this study adds to a growing body of research highlighting the need to reassess the prevalence of unnecessary interventions in low-risk pregnancies. We must shift our understanding of what constitutes a healthy labor and delivery, allowing women’s bodies the space to function naturally with less medical interference.
Let’s hope healthcare providers take note and begin embracing a more personalized approach to childbirth. It’s about time—literally.
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In summary, this recent study provides crucial insight into the variability of labor progression, challenging outdated norms and emphasizing the importance of personalized care in childbirth.
Keyphrase: Labor Progression Variability
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