From the Editor

21st Century norms for assessing the progress of labor

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Robert L. Barbieri, MD (Editorial, August 2013)

Management of labor is a clinical art, requiring the integration of many diverse pieces of information, including the medical conditions affecting the parturient, the strength and frequency of uterine contractions, the physical characteristics of the birth canal, the size and position of the fetus, status of the membranes, and assessment of the fetal physiologic state. The bottom line of the Zhang report2 is that 21st Century labor has a pace that is slower than the pace reported by Friedman1 based on data from the mid-20th Century. Adjust your practice to integrate these new labor progress norms into your decision making.

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