ArticleObstetrics and gynecology2010
Contemporary patterns of spontaneous labor with normal neonatal outcomes.
Article in Obstetrics and gynecology, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 207 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Effect of Epidural Analgesia on Labour and Neonatal and Maternal Outcomes in 1, 2a, 3, and 4a Robson's Classes: a Propensity Score-matched Analysis
Caffeine in the Second Stage: A Randomized Control Trial in Low-risk Nulliparous Mothers at Term
Impact of Low-Dose Epidural Analgesia on Labour Progression in Robson Class 1 Women: a Retrospective Study
Who cites it
207 citing papers in PubMed, 6 syntheses or guidelines pooled it, 781 citations in OpenAlex.
- Use of the peanut ball during labour: A systematic review and meta-analysis.Nursing open · 2021Pooled it
- Diagnostic accuracy of the partograph alert and action lines to predict adverse birth outcomes: a systematic review.BJOG : an international journal of obstetrics and gynaecology · 2019Pooled it
- Cervical dilatation patterns of 'low-risk' women with spontaneous labour and normal perinatal outcomes: a systematic review.BJOG : an international journal of obstetrics and gynaecology · 2018Pooled it
- Duration of spontaneous labour in 'low-risk' women with 'normal' perinatal outcomes: A systematic review.European journal of obstetrics, gynecology, and reproductive biology · 2018Pooled it
- Dysfunctional labor: Case definition & guidelines for data collection, analysis, and presentation of immunization safety data.Vaccine · 2017Guideline
- Diagnosing onset of labor: a systematic review of definitions in the research literature.BMC pregnancy and childbirth · 2016Pooled it
- The effect of mechanical massage on labor pain, duration and maternal satisfaction: a randomized controlled trial.BMC pregnancy and childbirth · 2025Trial
- Duration of the second and third stages of labor and risk of postpartum hemorrhage: a cohort study stratified by parity.BMC pregnancy and childbirth · 2025Trial
- The effect of Zhang's guideline vs the WHO partograph on childbirth experience measured by the Childbirth Experience Questionnaire in the Labor Progression Study (LaPS): A cluster randomized trial.Acta obstetricia et gynecologica Scandinavica · 2022Trial
- Comparing Different Partograph Designs for Use in Standard Labor Care: A Pilot Randomized Trial.Maternal and child health journal · 2018Trial
- Study protocol: the Labor Progression Study, LAPS - does the use of a dynamic progression guideline in labor reduce the rate of intrapartum cesarean sections in nulliparous women? A multicenter, cluster randomized trial in Norway.BMC pregnancy and childbirth · 2017Trial
- Selective episiotomy vs. implementation of a non-episiotomy protocol: a randomized clinical trial.Reproductive health · 2017Trial
- Foley catheter for induction of labor: potential barriers to adopting the technique.Journal of perinatology : official journal of the California Perinatal Association · 2015Trial
- Utility of Admission and Intrapartum Cardiotocography for Predicting Umbilical Artery pH Status at Birth: A Retrospective Cohort Study in Iran.Health science reports · 2026Article
- A Comparison of Midwives' Perceptions of the Labour Care Guide and the Traditional Partograph: A Multicenter Cross-Sectional Study.Healthcare (Basel, Switzerland) · 2026Article
- Article
- Episiotomy and the risk of obstetric anal sphincter injury in nulliparous women with a prolonged second stage.Archives of gynecology and obstetrics · 2026Article
- External validation of a machine learning model for delivery mode prediction after induction.NPJ digital medicine · 2026Article
- An Appraisal of Labor Augmentation: An Update on Current Evidence and Practice.Maternal-fetal medicine (Wolters Kluwer Health, Inc.) · 2026Review
- Time of day of induction impacts the total duration of labor.American journal of obstetrics & gynecology MFM · 2026Article
147 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
18 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo use contemporary labor data to examine the labor patterns in a large, modern obstetric population in the United States.
methodsData were from the Consortium on Safe Labor, a multicenter retrospective study that abstracted detailed labor and delivery information from electronic medical records in 19 hospitals across the United States. A total of 62,415 parturients were selected who had a singleton term gestation, spontaneous onset of labor, vertex presentation, vaginal delivery, and a normal perinatal outcome. A repeated-measures analysis was used to construct average labor curves by parity. An interval-censored regression was used to estimate duration of labor, stratified by cervical dilation at admission and centimeter by centimeter.
resultsLabor may take more than 6 hours to progress from 4 to 5 cm and more than 3 hours to progress from 5 to 6 cm of dilation. Nulliparous and multiparous women appeared to progress at a similar pace before 6 cm. However, after 6 cm, labor accelerated much faster in multiparous than in nulliparous women. The 95 percentiles of the second stage of labor in nulliparous women with and without epidural analgesia were 3.6 and 2.8 hours, respectively. A partogram for nulliparous women is proposed.
conclusionIn a large, contemporary population, the rate of cervical dilation accelerated after 6 cm, and progress from 4 cm to 6 cm was far slower than previously described. Allowing labor to continue for a longer period before 6 cm of cervical dilation may reduce the rate of intrapartum and subsequent repeat cesarean deliveries in the United States.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.