New Guidelines Say Give First-Time Pregnant Women More Time in Labor

Guest Author: Dr. Linda Burke-Galloway, MD

The American College of Obstetricians and Gynecologists and The Society for Maternal Fetal Medicine (aka high-risk obstetricians) have issued a new recommendation that is a game-changer in the manner that obstetrics is practiced: allow low-risk first-time pregnant moms more time in labor. This is assuming that the fetal tracing is normal and the mother does not have a fever, high blood pressure or a condition that could compromise her life or the life of her unborn baby. This recommendation is based on new evidence that demonstrates contradicts the old school Friedman Curve theory that active labor begins at 4 centimeters. It actually begins at 6 centimeters. This would be especially helpful to first-time teenage moms who might be forced to have future cesarean sections based on hospital rules and physician opinions if their first delivery was a cesarean section. The “once a C-section, always a C-Section” culture hits this particular group the hardest.

According to the new recommendations:

• Women should be allowed to push for at least two hours if they’ve given birth before, three hours if they are first-time mothers, and even longer in certain cases, such as when an epidural is used for pain relief.
• Vaginal delivery is the preferred option whenever possible and doctors should use techniques — forceps, for example — to assist with natural birth.
• Women should be advised to avoid excessive weight gain during pregnancy.

A word of caution should be offered about these recommendations: forceps deliveries are becoming a lost art and can cause more damage than good in the hands of an inexperienced provider and the “avoid excessive weight gain during pregnancy” is easier said than done for most women.

That being said, these new recommendations give first-time pregnant women the right to step on the proverbial brakes, the next time someone wants to rush their delivery via a C-section.

Dr. Linda Burke-Galloway is a board-certified ob-gyn physician with 30 years of clinical experience, author of a prenatal book and blogger who is passionate about teaching people how to understand their health conditions in order to obtain the best treatment possible. She is an alumnus of City College of New York, Columbia University School of Social Work and Boston University School of Medicine. In addition, she’s earned a certificate in Clinical Informatics at the Johns Hopkins School of Medicine. She is also a proud mother of two amazing sons and an international adoption advocate. Originally from Brooklyn, N.Y., she presently lives in Florida.