How Long is Labor and What’s the Deal with the Friedman Curve?

Posted On: September 15, 2022 By CIW

There are many myths and disinformation that spread between families, friends, and groups of people regarding labor and what is normal. Dr. Fox and Dr. Friedman, board-certified OB/GYNS try to clear up some of the questions regarding how long labor is supposed to be, and how exactly the Friedman curve plays into it all.

How Long is Labor Supposed to Be?

When it comes to labor, many women are interested to know how long it may take. “Well, like most things in pregnancy, it’s complicated,” said Dr. Friedman, “with a lot of individual factors.” This is because there are different stages of labor, so depending on which part of labor you are talking about, the length may vary. “There’s definitely a lot of human variation in this,” explained Dr. Fox. “And so, we try to not focus too much on calling something normal or abnormal.” The main thing doctors keep in mind is the safety of the mother and baby. If they believe that labor needs to be sped up or intervention is needed, then the length of labor may be cut short.

What are the Stages of Labor?

There are technically three stages of labor. The first stage is when the cervix is starting to dilate, and painful contractions are occurring. The second stage is when the cervix is fully dilated, and the mom begins pushing to help the baby pass through the vaginal canal. The third stage is the time between when the baby is born until the placenta is delivered.

Labor can also be broken up into the categories of latent labor vs. active labor. “So, we generally think about latent labor as that first part of labor, when your cervix is less dilated, and progress can be a little slower, and your contractions may be a little bit more irregular in both frequency and intensity,” explained Dr. Friedman. “And then active labor is towards the end of that process, the exact cut-off, again, is a little unclear and a little variable from person to person. But that’s generally when the cervix dilates more quickly, in a little bit more of a predictable fashion, and the contractions are generally regular, frequent, and painful (unless you have an epidural at that point).

What is the Friedman Curve?

Dr. Emmanuel Friedman created the Friedman Curve in the 1960s, which illustrates the traditionally expected rate of cervical dilation and duration of each stage of labor in a woman who has never given birth. Since his discovery, medical professionals have been following the Friedman Curve as a guide to what is normal when it comes to cervical dilation. In later years, however, the Friedman Curve has been re-studied. “As C-section rates went up in the country, there were various attempts to sort of look at why,” said Dr. Fox. “Why were C-sections happening and what could we do to try to prevent C-sections. And so, there came a lot of discussion about, well, maybe not all labors are “abnormal” if they don’t follow exactly the Friedman curve. And so, they started looking at it again. And thought, maybe things happen a little bit more slowly than we previously thought, and maybe that active phase doesn’t start for everybody at 4 centimeters.”

It turns out that not all women follow the Friedman Curve while giving birth, as each labor and delivery may differ. However, very long labor can be associated with certain complications such as the risk of infection or hemorrhage after delivery. When a woman is in labor for too long, the doctor may recommend augmentation with Pitocin and/or suggest that a C-section is the appropriate next step.  “My goal is to try to be as open and honest and communicative during the labor process so that nothing comes as a surprise, and that the patients know exactly, or as much as they possibly can, what I’m thinking and what I’m watching for,” explained Dr. Friedman. “So that when the time comes to make those recommendations, hopefully, they’re on board.”

To learn more about what to expect towards the end of pregnancy schedule an appointment with MFM Associates/Carnegie Imaging for Women specialist. Contact our office today!

Maternal Fetal Medicine blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!

Carnegie Imaging for Women blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!

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