Modern moms spend two more hours giving birth than women of the 1960s

By Jackie Farwell, BDN Staff
Posted April 02, 2012, at 8:11 p.m.

Today’s typical mother spends about two hours longer in labor than a woman who gave birth in the 1960s, a national study has found.

Modern moms are also older, heavier and more likely to encounter epidurals and cesarean sections than pregnant women of 50 years ago, according to researchers at the National Institutes of Health.

Patients and their babies have changed over the decades, but researchers said obstetricians’ approaches are driving longer labors.

Today’s mothers linger in the initial stage of labor for 2.6 hours longer with their first child and two hours longer for subsequent births, according to the study.

The analysis compared nearly 40,000 women who gave birth between 1959 and 1966 to about 100,000 women who delivered between 2002 and 2008.

Dr. Paul Smith, a Bangor obstetrician and gynecologist, said the study didn’t address the health implications of longer childbirth.

Women today tend to be much more active in delivery decisions than mothers of the 1960s, he said. That engagement results in healthier infants, making additional hours in the delivery room well worth it, he said.

“When you have dialogue between the doctor and his patient, that can add time but it can lead to better outcomes,” Smith said.

The study, published online in the American Journal of Obstetrics and Gynecology, doesn’t identify all the reasons that labors are getting longer. Differences in modern moms and their newborns compared to the 1960s may play a role.

Today’s first-time mothers have higher body mass indexes and are on average four years older when they give birth, the study found. Modern babies also are bigger and tend to arrive five days earlier.

Delivery practices also have changed. Cesarean deliveries have shot up, quadrupling since the 1960s to 12 percent of all births, according to the study.

Epidural injections that blunt the pain of labor were used in more than half of recent deliveries, compared with just 4 percent of births in the 1960s. Epidurals are known to prolong labor, but researchers said their rising prevalence doesn’t account fully for the findings.

Obstetricians also are administering oxytocin, a hormone that speeds labor, much more frequently than they did 50 years ago, which should have shortened overall labor times.

“Without it, labor might even be longer in current obstetrics than what we found,” the study’s lead author, Dr. Katherine Laughon of the National Institute of Child Health and Human Development, said in a release.

Geri Tamborelli, nursing director at the Family Birth Center at Maine Medical Center in Portland, noted that oxytocin also is used to induce labor, whether by the mother’s choice or medical necessity.

“What we’ve seen is a huge increase in inductions … When your body doesn’t put you into labor naturally, it takes longer,” Tamborelli said.

The center also is witnessing more obesity and Type 2 diabetes, which can lead to bigger babies, among its patients, she said.

Smith said his patients tend to be much heavier than the average body mass index of 25 cited in the study.

As for increasing use of epidurals, “I don’t know that women would want to suffer to go two hours faster,” he said.

The study’s authors called for further research into whether modern delivery practices are contributing to longer labors.

http://bangordailynews.com/2012/04/02/health/modern-moms-spend-two-more-hours-giving-birth-than-women-of-the-1960s/ printed on December 21, 2014