The rate of cervical dilation (cm/hour) in the ¢rst
stage of labor is the basis of decision making
for clinicians providing care to laboring women.
Once dilation is progressive or active, attempts to
accelerate labor may be justi¢ed if the dilation rate
becomes slower than the accepted minimum rate
for the population. However, the main interventions
used by clinicians in an attempt to accelerate labor,
amniotomy and oxytocin augmentation, are used at
such high rates in contemporary practice that
they are more the rule than the exception. This
is concerning because oxytocin is the drug most
commonly associated with preventable adverse
perinatal outcomes (Clark, Simpson, Knox, & Garite,
2009). Although it is undeniable that some
labor care providers use labor-accelerative interventions
injudiciously, the major underlying factor
leading to our high intervention rates may be that
common expectations of cervical dilation are unrealistically
fast. The unfortunate reality is that any
overuse of labor-accelerative intervention imposes
unnecessary risk on the unwitting maternal/fetal
unit.