II. Background
- Stage 1 of Labor is divided into two phases
- Latent Phase
- Active Phase
- Expected progress is based on Friedman Curve
- Assumes regular, frequent palpable contractions
III. Phase: Latent
- Definition
- Cervical dilation <6 cm and
- Regular contractions
- Normal Progress
- Nulliparous women
- Maximum normal duration <20 hours
- Multiparous women
- Maximum normal duration <14 hours
- Nulliparous women
- Management
- Avoid hospitalization in latent labor (<4-5 cm dilated, <80% effaced, non-painful contractions)
- Maximize hydration
- Facilitate rest and supportive environment
- Consider latent phase sedation (e.g. Hydroxyzine)
- See Non-Pharmacologic Pain Control in Labor
IV. Phase: Active
- Definition
- Cervical dilation >6 cm and
- Regular contractions
- Normal Progress
- Nulliparous women
- Cervical Dilation: >1.2 cm/hour
- Fetal Descent: >1 cm/hour
- Duration <8.6 hours
- Multiparous women
- Cervical Dilation: >1.5 cm/hour
- Fetal Descent: >2 cm/hour
- Duration <7.5 hours
- Nulliparous women
- Management
- See Labor Dystocia
- Consider Active Management of Labor
- Consider Amniotomy
- See Fetal Heart Tracing
- See Active Labor Anesthesia