ACTIVE MANAGEMENT OF LABOR

Active management of labor was first instituted as a program to shorte n the length of nulliparous labor. Numerous institutions have found th at implementation of this program decreased rates of cesarean section. Two randomized trials have evaluated this program, with both showing that labor was shortened by approximately 2 hours and maternal infecti ous morbidity was decreased by approximately 50%. Although one trial d emonstrated a significant reduction in the rate of cesarean birth, the other did not. No users have reported any increase in neonatal morbid ity. For some institutions implementation of active management of labo r principles may be one approach to decrease operative deliveries for dystocia.