Leah L. Albers, CNM, DrPH, FACNM, FAAN, is a Professor at the University of New Mexico Health Sciences Center, College of Nursing and Department of Obstetrics and Gynecology, School of Medicine. She is a midwifery teacher and researcher.
The Evidence for Physiologic Management of the Active Phase of the First Stage of Labor
Article first published online: 24 DEC 2010
2007 American College of Nurse Midwives
Journal of Midwifery & Womens Health
Volume 52, Issue 3, pages 207–215, May-June 2007
How to Cite
Albers, L. L. (2007), The Evidence for Physiologic Management of the Active Phase of the First Stage of Labor. Journal of Midwifery & Womens Health, 52: 207–215. doi: 10.1016/j.jmwh.2006.12.009
- Issue published online: 24 DEC 2010
- Article first published online: 24 DEC 2010
- active phase labor;
- continuous support;
- first stage labor;
- labor management;
- midwifery care
The active phase of first stage labor is generally defined as the period between 3 cm to 4 cm to complete cervical dilatation, in the presence of regular uterine contractions. Most women will experience this portion of labor within hospital obstetric units, where care commonly features restriction to bed, electronic fetal monitoring, early treatment of “slow” labors, and few pain management options beyond epidurals and narcotics. However, the available evidence on appropriate care for healthy childbearing women favors activity in labor, intermittent auscultation, patience from caregivers, and nonpharmacologic methods of pain relief. This article reviews the evidence for care practices that support physiologic labor. Modifying intrapartum care to reflect current evidence will improve women's health, and will require a multilevel approach and consistent midwifery demonstration of the model.