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Updated: Apr 15, 2026

Author Spotlight: Advancing Labor Management Through Electromyometrial Imaging for Understanding Uterine Contractions
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Second stage of labor.

Yvonne W Cheng1, Aaron B Caughey

  • 1*Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of California Davis, Sacramento, California †Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon.

Clinical Obstetrics and Gynecology
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Summary
This summary is machine-generated.

The definition of prolonged second stage labor may need updating due to changes in modern obstetrics. Optimal management strategies require further investigation for improved maternal and neonatal outcomes.

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Labor and Delivery

Background:

  • Current definitions of prolonged second stage labor, based on 1950s norms, diagnose a significant percentage of nulliparous and multiparous women.
  • Modern obstetric practices and population characteristics may differ from historical standards, potentially impacting labor progression.
  • The optimal management of the second stage of labor, particularly concerning epidural use, remains a subject of debate.

Purpose of the Study:

  • To evaluate the current definition of prolonged second stage labor in the context of contemporary obstetric practice.
  • To explore the potential need for revised labor progression norms.
  • To review the existing evidence on the management of the second stage and its impact on maternal and neonatal outcomes.

Main Methods:

  • Review of current literature and clinical guidelines.
  • Analysis of epidemiological data on labor progression.
  • Examination of studies on maternal and neonatal morbidity associated with second stage duration.

Main Results:

  • Prolonged second stage diagnoses affect 10-14% of nulliparous and 3-3.5% of multiparous women.
  • Evidence suggests a potential deviation from historical labor norms.
  • Maternal morbidity is linked to prolonged second stage, but neonatal outcomes data are conflicting.

Conclusions:

  • The established definitions for prolonged second stage labor may require re-evaluation.
  • Further research is needed to refine management protocols for the second stage of labor.
  • Clarifying the association between second stage duration and neonatal outcomes is crucial for evidence-based practice.