Once the mechanisms that trigger labor begin, the dilation stage begins, which is divided into two phases: the latent phase and the active phase. The latent phase, develops up to four centimeters of dilation and the active phase goes from four centimeters to ten with an average of eight hours, between both stages, for first-time mothers and five for the most experienced, according to the Guide Clinical Practice on Normal Delivery Care edited by the Ministry of Health in 2010.
Until now there was a widely accepted reference that came to say that vaginal births developed with a dilation of approximately one centimeter every hour. Well, according to a study published in 'PLOS Medicine' by Olufemi Oladapo, doctor of the Department of Reproductive Health and Research of the World Health Organization (WHO) Cervical dilation during the process of vaginal delivery can progress more slowly in many women.
To carry out this study, which is part of the 'Better Bold in Work Difficulty' (BOLD) project, they have participated researchers from nine countries: Switzerland, Nigeria, Uganda, United Kingdom, South Africa, China, United States, as well as the University of São Paulo (Brazil) and the Institute of Clinical and Health Effectiveness (IECS) of Argentina. His work has been developed taking as reference the patterns of progression of spontaneous birth of 5,606 women who gave birth vaginally in Nigeria and Uganda.
THEY CONCLUSED THAT THE AVERAGE TIME TO ADVANCE A CENTIMETER IN THE DILATATION EXCEEDED ONE HOUR UNTIL REACHING THE FIVE CENTIMETERS IN ALL MOTHERS.First time, more dilation time
As the study indicates, first-time women can take up to 7 hours to progress from 4 to 5 cm. and more than 3 hours to progress from 5 to 6 cm. According to the average, those admitted with 4 cm., 5 cm. and 6 cm. show that the work could last 14, 11 and 9 hours, respectively.
There is no need to intervene
The truth is that each woman is different and at the same time each birth can develop very differently. But in general, the study reinforces the idea that labor takes time and that it is not necessary to accelerate a natural process if the expected centimeter of expansion every hour is not fulfilled. The researchers point out that intervening before reaching cervical dilation of five centimeters is inappropriate.
"Our data on the progression of the birth process clearly demonstrate that a cervical dilation rate of one centimeter every hour, traditionally described, can be an irreversibly fast time for some women and therefore should not be applied universally to identify abnormalities in progress of childbirth. "
The World Health Organization has already made public its recommendations when conducting labor, advising to limit induction when there are really medical reasons that indicate it because if we do so, the risk of greater instrumentalization increases.
Giving birth is something that women have been doing for a long time before the existence of ultrasound, oxytocin, epidural, caesarean sections ... and it always is and will be something natural. It is true that sometimes there may be complications that endanger the life of the mother or the baby and the intervention of medical professionals is necessary, but if everything is normal, the ideal is to flee from procedures such as induction with oxytocin, which could raise the risk of instrumentalization and that the delivery ends in caesarean section.
Be that as it may, the ideal is to take note of studies like this to bet on natural and respected births wherever the mother herself decides on the medical recommendations that her evolution entails.
And your delivery, was what is usually called "a short hour"? Did it get longer than expected? Tell us in the comments!
