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More labour time can cut Caesarean delivery rates by half


New York: When women in labour are given more time to deliver their baby than current guidelines recommend in the US, their incidence of Caesarean delivery drops by 55 percent, say researchers.

The researchers tested what happens when women in the second stage of labour (fully dilated) are given four hours, instead of three, if they did have an epidural.

Not only was the incidence of Caesarean delivery reduced by more than 50 percent, there were no associated negative health consequences to the mother or child, said the study’s lead author Alexis Gimovsky fromThe Sidney Kimmel Medical College of Thomas Jefferson University in Philadelphia, US.

“This was a small study, so a formal change in guidelines should be based on a larger sample of women. But this study shows what we have observed in practice — there is benefit to allowing women to labour longer,” Gimovsky said.

The study was published in the American Journal of Obstetrics and Gynecology.

About 30 percent of deliveries in the US end with a caesarean, which can put a woman at risk for a number of complications in following pregnancies, can impact fetal health, and which are very costly, Gimovsky pointed out.

In this study, the researchers enrolled 78 first time mothers who were between 36-41 weeks of gestation.

They were randomised to an “extended labour” group that allowed for at least one additional hour of labour, or to a “usual labour” group that followed current delivery guidelines.

At time of delivery, all of the study participants chose to have an epidural. Almost half of the women had an induced labour.

They found that incidence of Caesarean delivery was about 19.5 percent (eight out of 41 women) in the extended labour group and about 43 percent (16 of 37 women) in the usual labour group.

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