Active Management of Labor Shortens Labor
but
Does Not Reduce the C-Section Rate

Researchers in Boston randomly assigned 1,934 low risk women with no history of a prior delivery to active management of labor or to usual labor care.

They found no difference between the two groups in terms of C/S rates, but did find that active management shortened the median duration of labor by 2.7 hours.

The percentage of women in whom labor lasted longer that 12 hours was three times higher in the usual care group than in the active management group.

Active management of labor is characterized by:

  • strict criteria for the diagnosis of labor,
  • early rupture of the amniotic membranes,
  • prompt intervention with oxytocin in the event of inefficient uterine contractions,
  • and a commitment not to leave a woman unattended during labor.

New England Journal of Medicine 333:745, 1995.

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