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Active management of labour

¹Centre for Reproduction, Growth and Development, University of Leeds, UK. J.G.Thornton@LEEDS.AC.UK

Current Opinion in Obstetrics & Gynecology

|January 13, 1998

Summary

Active management of labor care shows limited evidence for reducing cesarean or operative delivery rates. While psychological support is most effective, evidence quality is often low, though labor duration may be slightly reduced.

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Area of Science:

Obstetrics and Gynecology
Evidence-Based Medicine

Background:

The 'active management' package of care during labor is a common intervention.
Its effectiveness in reducing operative delivery rates remains debated.

Purpose of the Study:

To evaluate the evidence for the effectiveness of the 'active management' package in labor.
To assess its impact on cesarean section and operative delivery rates.

Main Methods:

Systematic review and meta-analysis of existing trials on active labor management.
Assessment of study quality and evidence strength.

Main Results:

No strong evidence supports the 'active management' package reducing cesarean or operative delivery rates.
Psychological support within the package shows the most effectiveness, but trials are often low quality.
Evidence for shortening labor duration is stronger, but effects are small in high-quality studies.

Conclusions:

The 'active management' package of labor care lacks robust evidence for reducing operative delivery rates.
Psychological support is a promising component, but requires higher quality research.
A small reduction in labor duration may be associated with the package.

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