Labour longer for women now than 50 years ago

Women today are spending longer in labour than half a century back. After comparing data on nearly 1.4 lakh deliveries between 1960 and 2000, scientists have found that the first stage of labour had increased by 2.6 hours for first-time mothers.

For women who had previously given birth, this early stage of labour took two hours longer in recent years than for women in the 1960s. Infants born in the contemporary group were born five days earlier, on average, than were those born in the 1960s, and tended to weigh more. The women in the contemporary group tended to weigh more than those who delivered in the 1960s.

For the contemporary group, the average body mass index (measure of body fat based on height and weight) before pregnancy was 24.9, compared with 23 for the earlier generation. At the time they gave birth, the mothers in the contemporary group were about four years older, on average, than those in the group who gave birth in the 1960s.

The study by the National Institutes of Health (NIH) has been published in the American Journal of Obstetrics and Gynecology. Indian gynecologists agree to the findings. Head of Max Hospital's department of gynecology Dr Anuradha Kapur said, "The BMI of an average Indian woman has increased over the last 50 years, thanks to good nutrition, high fat diet and fast food. If an average woman in the 1960s had a BMI of 23, it would easily be 27 now."

Dr Kapur added, "Child birth too has got delayed with more women having a successful career and becoming financially independent. If the first baby was born to a woman 50 years back when she was 20, now it's more like when she is 28. Also, the average baby now weight over 3 kg as against less than 2.5 kg earlier."

NIH researchers, however, could not identify all the factors that accounted for the increase, but concluded that the change was likely due to changes in delivery room practices.

"Older mothers tend to take longer to give birth than do younger mothers," said the study's lead author, S Katherine Laughon, of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). "But when we take maternal age into account, it doesn't completely explain the difference in labour times."

Among the changes in delivery practice the researchers found was an increase in the use of epidural anesthesia, the injection of pain killers into the spinal fluid, to decrease the pain of labour. For the contemporary group, epidural injections were used in more than half of recent deliveries, compared with 4% of deliveries in the 1960s.

The study authors noted that epidural anesthesia is known to increase delivery time, but said it doesn't account for all of the increase. Doctors in the early 2000s also administered the hormone oxytocin more frequently (in 31% of deliveries, compared with 12% in the 1960s), the researchers found.

Oxytocin is given to speed up labour, often when contractions seem to have slowed. Its use should be expected to shorten labour times, Dr Laughon explained. "Without it, labour might even be longer in current obstetrics than what we found," she said.

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