Babies Take Longer To Come Out Than They Did In Grandma's Day

[xchrom]

http://www.wbur.org/npr/149718838/babies-take-longer-to-come-out-than-they-did-in-grandmas-day

?t=1333148657&s=4
Fifty years ago, the typical first-time mother in the U.S. took about four hours to give birth. These days, women labor about 6 1/2 hours. (Carsten/Three Lions / Getty Images)

The typical first-time mother takes 6 1/2 hours to give birth these days. Her counterpart 50 years ago labored for barely four hours.

That's the striking conclusion of a new federal study that compared nearly 140,000 births from two time periods.

One big implication: Today's obstetricians may be rushing to do cesarean sections too soon because they're using an out-of-date yardstick for how long a "normal" labor should take.

"That's absolutely correct," says Dr. Ware Branch of Intermountain Healthcare in Salt Lake City, a study author. Lead author Dr. Katherine Laughon of the National Institute of Child Health and Human Development agrees.

The definition of a "normal" labor — the range of times when a woman in labor reaches certain milestones — was laid down in the 1950s. Contemporary obstetricians still use that "labor curve."

[Old Union Guy]

1. Seriously I'm not getting this.

They are in a rush to do cesareans causes longer labor how?

[surrealAmerican]

2. That's not a cause ...

... it's an effect. If labor goes on "too long", they will do a cesarean. They are using outdated information to determine how much time "too long" is.

[gkhouston]

15. +1. I can't tell you how many people are whomper-jawed when I tell them

that I was in labor for 48 hours. And it's not the idea that someone would be in labor for that long that surprises them; it's that I was "allowed" to labor that long.

[Tumbulu]

17. People don't even want to hear about my 52 hr labor.....

thank goodness the midwives were patient! Plus they kept a close eye on my baby to make sure that nothing was going wrong....

But my goodness, what a job that was!

Did you have midwives as well?

[gkhouston]

19. It was a practice of physicians and midwives.

Mostly, I saw the midwives. By the time I actually delivered, I think half the hospital was in the room.

[Tumbulu]

20. mine was too, midwives with physicians at a birthing wing

in the hospital. It was so very hard....but I think worth it.

I do not understand the lack of interest in natural childbirth these days. Among the nieces within my family not one has had an epidural free labor. And among my siblings, their parents, all had their children using natural childbirth.

It is as though this generation of women do not think it makes any sense to go the medication free route.

[noamnety]

22. I guess I'm in that new generation.

I didn't feel the need to prove anything to myself or the rest of the world by going through intense pain just for the hell of it.

In the end I needed a c-section anyway because the cord was wrapped around her neck and cutting off her blood supply, we lost her heart beat on the monitor. But the 32 hours I was in labor - I can't say it would have improved my life in any way whatsoever to deal with agonizing pain for that entire time. It's like when I have a migraine, I don't need to prove my feminist credentials by foregoing the excedrin. Pain sucks. I don't like it.

[Tumbulu]

23. Do you think that medication free means that one is trying to prove something?

Thank you for responding.

It was not that for me- it was about not complicating the delivery with additional uncertainties and risks. And subjecting my child to unnecessary drugs.

I do not use anything at the dentists either, most of the time. Even had 8 root canals without painkiller as the way my body reacts to the painkillers is worse for me than the actual pain.

And where does the idea that not medicating a migraine is something feminists would do?

I am a bit mystified and would really like to understand your perspective as it seems to be popular among the youth of today.

[noamnety]

24. I've seen the attitude promoted before

that if you use painkillers, you aren't as "good" of a woman during childbirth.

Similarly, I've heard discussions by feminists or read them online (even on old DU) that there's something antifeminist about not embracing your period, that it's antifeminist to get surgery to make it stop if it's causing problems, etc.

I'm just saying that there's no shame in treating pain, it doesn't make you less of a feminist or make you have less value as a person if you use painkillers (whether it's child birth, dentistry, or migraines or menstrual pain).

I don't like reading those views promoted, they were in part responsible for me putting up with decades of really bad cramping - it wasn't til last summer that I finally told my doctor I was freaking sick of this, and based on that conversation I had an ultrasound, found out I had cysts and endometriosis which I probably had for decades, got myself lasered out (no more periods!), and realized I can be a hell of a lot happier painfree and period free. I wish I hadn't listened to the whole anti-painkiller as a badge of womanhood crap and hadn't waited til I was almost 50 to put my foot down and say that this doesn't have to be part of my life.

I'm mystified as to why anyone else would be mystified at my attitude: Excruciating pain is excruciatingly painful and I avoid it when possible.

[Tumbulu]

25. I guess it boils down to if you trust the safety of painkillers

for me that is what it is about. I don't trust that they are safe. I prefer pain to them as they make me feel so sick for so long.

Now, for operations, general anesthesia, there is not choice as far as I am concerned. But I really think hard before taking an aspirin or advil...I consider the health of my kidneys and liver. At the most I can take perhaps 2 a day....

I am glad that for you painkillers present no problem and that you are helped by them. I do not love pain. I just prefer pain that lasts a short time over a long painful recovery- which is what I get from the dental anesthesia.

I did not want my baby exposed to those chemicals either.

I think that this attitude of skepticism regarding the safety of painkillers is perhaps more prevalent in my generation. I do not think it is a feminism issue at all. I think it is a generational one.

[Ilsa]

3. Women now are hooked up to fetal monitors

and sometimes IVs. Their movements are restricted and they usually are in bed for most of the labor. It is possible that the inactivity plays into the length of the labor, too, along with the spinal anesthesia or oral medications used to "take the edge off." The longer labors vs 50-60 years ago doesn't surprise me.

[Crunchy Frog]

21. 50-60 years ago, women tended to be whacked out on scopolamine

and had their babies dragged out with forceps.

But, there was alot fewer inductions going on, and it's possible that women went into the hospital later.

[HereSince1628]

4. Women are 4 years older now? I thought there was a teen-mom epidemic

that would have that number the other way.

[no_hypocrisy]

5. There was a period in the Seventies where many women opted to deliver

at home. They eschewed all anesthesia. They gave birth in their own beds or even their bathtubs/Leboyer method (http://healthpsych.psy.vanderbilt.edu/WaterBabies.htm). Their family and friends visiting throughout the day/night. The mothers could get up and walk around periodically. Sometimes a midwife would be in attendance and a doula to help with the infant after birth.

I know hospitals tried to compete by providing "birthing rooms" that resembled bedrooms (with rocking chairs and afghans on the beds). But it wasn't the same as home birthing.

[handmade34]

9. yup

mine were all born at home and it was wonderful!! (last one in '89) I have eternal graditude for my midwives

[mopinko]

10. i had 4 at home. the c-sect rate

for the practice was 3%. they didn't follow any damn "labor curve".

[kickysnana]

6. Babies are also bigger now because women no longer smoke, drink etc during pregnancy. n/t

My sisters an my babies 1974-2006 were all over 7 lbs. Moms 5 were always under.

[surrealAmerican]

7. ... also, back int the '50s and '60, ...

... women were generally advised to gain much less weight during pregnancy than they are now.

[cbayer]

8. Epidurals are probably the main cause. Women don't push because they don't feel anything.

[Warpy]

12. Pushing is usually intact with an epidural

It's given below the nerves that control the abdominal muscles and only numbs the cervix and perineum and everything below.

[cbayer]

13. You are correct if it is done correctly, but the sensations that lead to the urge to push

are gone. So you can push on demand, but it's different.

From the article:

"Laughon says part of the reason is a jump in the use of epidural anesthesia during labor.

"That is known to prolong labor by approximately 40 to 90 minutes," Laughon says. "Of course, it's very accepted practice to help improve pain control during labor."

[Warpy]

14. Then it's the doctor's fault for not being there and telling her to push

because most women can, and push effectively. It does need to be on command, though, since she can't feel the contractions, and thank goodness for that.

[Warpy]

11. Probably because first time moms get to the hospital sooner

and quite possibly invasive equipment that ties them to beds instead of allowing them to walk and hurry things along also lengthens labor.

[semillama]

16. Can you blame them? n/t

[Chemisse]

18. These labor numbers don't seem right.

Six hours is a very fast labor, and is hardly typical.

If it is the first time that a woman is having a baby, labor usually lasts between 12 and 14 hours; in pregnancies that follow, labor is often shorter, averaging between six and eight hours.
http://www.cedars-sinai.edu/Patients/Health-Conditions/Pregnancy---Labor.aspx