As you know, because this is not new, the rate of caesarean section in childbirth is very high in most countries and that involves risks for the mother and the baby, especially when it is not justified, or when it could be avoided.
To try to improve this it has been decided to try to see what happens if doctors skip the guides and give more time to the woman in the last phase of labor. Surprisingly, or maybe not so much, leaving one more hour at the end of the birth the probability of having a caesarean section is almost half.
The "renewed" guides of 1800
Apparently, as mentioned in the study, the current guidelines on which professionals rely to determine how long to wait were written in 1800, when they were created based on the opinion of the experts of that time. Since then no randomized controlled trials have been conducted and the data available are retrospective and the results may vary due to various related factors.
Faced with this situation, researchers from the University of Philadelphia They decided to carry out this research, in order to know if waiting a little longer than what the guides recommend could benefit the mother and the baby. The study was published in the magazine American Journal of Obstetrics and Gynecology and it represents an open door to other associated research evaluating current guidelines.
Wait more, when?
Perhaps you wonder what we mean by "wait a little while longer". We talk about the second stage of labor, which happens from the moment the dilation is complete and the baby is born. This second stage is divided into the passive phase, when there is no feeling of pushing and the contractions are lowering the baby's head, which lasts between one and two hours, and the active phase, which is when there is a feeling of pushing and the baby It starts to appear. This phase also lasts between one hour and two hours (it is considered to be one hour without epidural and two with epidural).
Well, for the study he took a sample of 78 women without children They were going to give birth to their first baby. They were randomized into two groups (all of them were given epidural analgesia): those that after 3 hours in the second phase of labor had not given birth and delivery was accelerated or caesarean section was performed, as was usually done, and the group of those who, after 3 hours in the second phase of labor, waited another hour to see what happened.
Almost half the chance that he would end up in caesarean section
When comparing the results between both groups, they saw that the incidence of cesarean delivery was 19.5% in the group of women who had more time to give birth (8 of 41 deliveries) and 43,2% (16 of 37 deliveries) in the working group according to the usual recommendations. They also saw that there were no significant differences in maternal or neonatal morbidity outcomes, that is, waiting longer did not harm the mother or the baby.
But also, the rates are very high!
It is true. 43.2% of C-sections are a shameful percentage, because it implies that 4 out of 10 women are not able to give birth by their own means. It seems, therefore, that they have remained halfway, because they have achieved that the other group of women has a caesarean section rate of 19.5%, which is much better, but still high for what is considered acceptable in the western world (between 10 and 15% of births).
So, concluding, it is good news that they have finally done a study that demonstrates something that seems obvious and logical: as long as the baby is well and the mother too, time should not be an obstacle, which is another way of saying that if many babies are not born within three hours of starting the second phase of labor, it may be because it is normal.
Now they just need to take a little more value and decide to do another study, with many more women, that 78 are very few, that extend four hours to four and a half hours, or five ... because I repeat, while mom and baby are well , nature can be capricious in this regard and be slower of what the experts of the 1800s considered to be normal.
