Childbirth takes 2 hours longer than 50 years ago

By Rachael Rettner
MyHealthNewsDaily

For all our advances in medicine, women spend longer in labor now than they did 50 years ago, a new study says.

Women in the study who delivered babies in the mid-2000s took, on average, about 2 hours longer to get through the first stage of labor compared with women who gave birth in the 1950s and 1960s. In the first stage of labor, the cervix opens until it is wide enough to allow the baby's head to pass; the second stage is the actual delivery of the baby.

The findings held even after the researchers took into account differences between the women in the two groups, including their weight, age and ethnicity. Women in the contemporary group tended to be older and weigh more than women in the group that gave birth 50 years ago.

The study suggests that changes in delivery practices, such as more common use of epidurals, may be in part responsible for today's longer labor times, the researchers say.

The study will be published in an upcoming issue of the American Journal of Obstetrics and Gynecology.

Dr. S. Katherine Laughon, of the National Institutes of Health, and colleagues analyzed historic records from 39,491 women who gave birth between 1959 and 1966, and contemporary records of 98,359 women who gave birth between 2002 and 2008. The study included only women who entered labor spontaneously (not those who were induced), and were pregnant with one child.

Fifty-five percent of women in the contemporary group received an epidural, while just 4 percent in the historic group did. The rates for use of oxytocin were 31 percent for women in the contemporary group and 12 percent in the historic group. Epidurals are given to relieve pain; oxytocin can be given to women already in labor to strengthen contractions or speed the progress.  

The rate of cesarean section was four times higher in the contemporary group compared to the historic group.

Use of forceps and surgical instruments to extract the baby from the birth canal was more common in the historic group than in the contemporary group.

Women in the contemporary group in their first pregnancy took 2.6 hours longer to complete the first stage of labor compared with women in the historic group also in their first pregnancy. Women in the contemporary group who had had a previous pregnancy took about 2 hours longer to complete the first stage of labor.

The second stage of labor, which ends when the baby is born, was also longer for women in the contemporary group, but the difference was much smaller than the first stage — a few minutes instead of hours.

The researchers don't know exactly why labors are longer today. Epidurals have been found to prolong labor by about 40 to 90 minutes, but they are favored over other methods of pain relief, the researchers say.

More research is needed to find out what other factors increase labor times, the researchers say.

"Women may simply need more time to deliver than they used to," Laughon said.

The finding is important because the definition of "normal" labor time is based on data from the 1950s,Laughon said. This may mean doctors should now wait longer before administering drugs to speed up the labor (including oxytocin) or intervening with a C-section, Laughon said.

Longer labors also increase medical costs. The extra time it took women in the contemporary group to give birth would be expected to increase the cost of each birth by $110, the researchers said.

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Discuss this post

It cost 380.00 in the 50's to go to the hospital, have your baby, spend two nights in the hospital and get fed for 2 days.

  • 3 votes
Reply#1 - Fri Mar 30, 2012 7:40 PM EDT

Women in the 50s and 60s stayed in the hospital for several days after childbirth, usually.

    #1.1 - Wed Apr 4, 2012 12:42 AM EDT

    That's because of the process at that time. You had mothers who were having to come out of anesthsia and during this time there was a lot of advancement on tools used to get the baby out of the mother. Usually this caused more damage to the mother's body than what happens now since we are getting to the point of having less evasive practices and equipment. And even some of these tools they used back then are not used now because of new options or you had mothers dying of complications from the practices of that time.

      #1.2 - Thu Apr 5, 2012 6:48 PM EDT

      That's interesting, because natural childbirth was not the primary mode of delivery then. My grandmother was given systemic anesthesia then.

      In the 1940s and 1950s women flocked to the hospital to give birth. Male physicians attended the births. It became common practice to anesthetize women during labor to eliminate any pain during childbirth. The expectant father was relegated to the waiting room to protect him from the "gruesome reality" of childbirth.

      Drug use aside, perhaps because more women work outside the home now... which contributes to the production of necessary hormones (cortisol, etc)?

        #1.3 - Thu Jun 28, 2012 8:32 AM EDT
        Reply

        Could endless hours of sitting (desk, car, couch) possibly have something to do with longer labor in childbirth these days?

        • 4 votes
        Reply#2 - Sat Mar 31, 2012 9:19 PM EDT

        I think that's probably part of it. I think another factor is as mentioned in the article - older mothers and mothers (and possibly babies) who weigh more.

        • 1 vote
        #2.1 - Sun Apr 1, 2012 4:54 PM EDT

        I agree. More exercise and less sitting around is needed not just for women, but for the general population. We're all becoming way too soft!

        • 2 votes
        #2.2 - Tue Apr 3, 2012 5:56 AM EDT

        Yes I belive so, when i was pregnant with my only child, i had walked two miles every day untill i gave birth to my child. I always dreaded that i was going to be in the hospital for ever, but went in to labor at 3am in the morning, got to the hospital in 1 hour later, and was told i was dilated at 7. at around some time at 8am i was told to push, and after 45 minutes, out baby came. So yes exercise and all the walking helped me alot.

        • 3 votes
        #2.3 - Tue Apr 3, 2012 11:35 AM EDT

        Back in the 50s and 60s, they knocked women out with scopalamine and yanked the babies out with forceps. Of course it was quicker.

        • 3 votes
        #2.4 - Wed Apr 4, 2012 12:38 AM EDT

        There's that, too. Still happened in 70's. There were 3 kids in my family, and my mom only remembers delivering my sister (the youngest, born in '78), who was born in the hallway before they could get Mom to the delivery room and under anesthesia. She was unconscious for me and my brother - the doctor didn't even give her the option of a natural childbirth.

          #2.5 - Wed Apr 4, 2012 12:25 PM EDT
          Reply

          Or maybe because of our need to 'schedule' childbirth with medically unnecessary inductions instead of letting the body go into labor naturally.

          • 2 votes
          Reply#3 - Sun Apr 1, 2012 9:03 AM EDT

          The study did not include women whose labors were induced.

          • 1 vote
          #3.1 - Sun Apr 1, 2012 1:07 PM EDT

          Oops...I see that now. I actually looked for that but must not have read closely enough the first time. Thanks.

          • 1 vote
          #3.2 - Sun Apr 1, 2012 4:13 PM EDT

          No problem.

            #3.3 - Sun Apr 1, 2012 4:51 PM EDT

            It's hard to find a woman in my region who hasn't been induced. I think they're over doing the induction thing. I had 4 kids and was never induced... was on time for one, 1-2 weeks late for two, and a little over 3 weeks late for one. Now they say you must be induced if you're going to be a week late. Personally, I think it's to make the docs' lives easier!

              #3.4 - Thu Apr 5, 2012 11:03 PM EDT

              The patient can refuse to be induced.

                #3.5 - Fri Apr 6, 2012 1:54 PM EDT

                If you are 2 weeks past the due date, there are dangers to the baby. My son was 2 weeks past and the reason why I did not go into labor was because he was tangled in the cord (he would not drop). They could not see this on ultrsound and they did not even believe me when I said he wasn't moving anymore (because they still heard a heart beat). Not until his heart rate started bouncing around did they induce and then I waited 16 hours without an epidural before an emergency c-section.

                More than once have I been poo pooed by physicians only to find out many months or years later that there really was something wrong!

                  #3.6 - Thu Jun 28, 2012 8:40 AM EDT
                  Reply

                  I think maybe women rush to the hospital sooner, I gave birth in an office setting rather than a hospital and didn't go until my contractions were 2 mins apart, I walked around, cleaned the house, folded clothes in the early stage. I was at the Dr.s office 2.5 hours before my first baby was delivered and 50 mins before the second. Being on your feet lets gravity help with the process.

                    Reply#4 - Tue Apr 3, 2012 12:39 PM EDT

                    The study suggests that changes in delivery practices, such as more common use of epidurals, may be in part responsible for today's longer labor times, the researchers say.

                    May be in part? How about it IS in part. You have so many doctors trying to control when women give birth that it does cause the process to be longer. You have drugs to slow the contractions and drugs to speed it up all based on the doctor. There are times when these are needed for those situations that are becoming HIGH-RISK, but for other situations some of these drugs are not needed. If coached properly during the birthing process, women really don't need a portion of these drugs. Just because it's convenient doesn't mean it's the best. A 2 hour delay could also have it's own risk for the health of the baby and mother. I've read a few cases where the baby starts having complications due to the medication they are giving the mother. The baby goes into distress and the heart rate begins to drop.

                    • 1 vote
                    Reply#5 - Thu Apr 5, 2012 6:39 PM EDT

                    The researchers don't know exactly why labors are longer today. Epidurals have been found to prolong labor by about 40 to 90 minutes, but they are favored over other methods of pain relief, the researchers say.

                    Say what? Anyone else see a problem with this statement?

                    • 2 votes
                    Reply#6 - Thu Apr 5, 2012 9:19 PM EDT
                    Reply

                    Babies are also larger now and as a society, our work is more sedentary. Both can prolong labor. It's probably a combination of factors, but in the grand scheme of things, does it really matter?

                    • 1 vote
                    Reply#7 - Wed May 1, 2013 9:29 PM EDT
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