Active Management of Labor

Active management of labor is program hospitals adopted to help prevent long labors. Designed in Dublin Ireland in the 1970's, it was hoped to help first time mothers have better birth experiences. The comprehensive program requires the mother be in active labor before she is admitted to the hospital. Once admitted, the labor is sped up with an early amniotomy and early artificial oxytocin. The mother also receives continuous professional labor support.

Using this program, the doctors and midwives at National Maternity Hospital were able to guarantee a woman would not be in labor for more than 12 hours. The program caught on around the world, but without two key factors, the strict criteria to determine the mother is in active labor and the continuous professional labor support.

The only published studies on active management show it does not have any significant impact on reducing cesarean rates, use of epidural or problems with babies. It only shortens the length of labor. However, half the women who are considered to have poor progress in labor will progress well whether they have artificial oxytocin or not. When the components of active management are evaluated independently, the only part that actually improves outcomes for mothers and babies is continuous professional labor support.

It is helpful to know your midwife's idea of how labor should progress, and what methods she will use to encourage progress.

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