American College of Obstetricians and Gynecologist's Recent Guidelines to Prevent the Primary Cesarean
"The Consortium on Safe Labor data highlight two important features of contemporary labor progress (Fig. 4). First, from 4–6 cm, nulliparous and multiparous women dilated at essentially the same rate, and more slowly than historically described....The Consortium on Safe Labor data do not directly address an optimal duration for the diagnosis of active phase protraction or labor arrest, but do suggest that neither should be diagnosed before 6 cm of dilation. Because they are contemporary and robust, it seems that the Consortium on Safe Labor data, rather than the standards proposed by Friedman, should inform evidence-based labor management."
"Published data indicate that one of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula. A Cochrane meta-analysis of 12 trials and more than 15,000 women demonstrated that the presence of continuous one-on-one support during labor and delivery was associated with improved patient satisfaction and a statistically significant reduction in the rate of cesarean delivery"
American College of Obstetricians and Gynecologist's Summary of Recent Guidelines in a 2014 News-Release
