First Stage

This stage is further divided into latent, active, and transition phases. It's during this stage that
the cervix dilates and effaces (thins out). The latent phase can take a variable amount of time
and is often the longest. The active phase sees more rapid cervical dilation, and the transition
phase is characterized by intense contractions.
Friedman’s Curve
Friedman's curve is a graphical representation of the progress of cervical dilation and fetal
descent during labor. It was developed by Dr. Emmanuel A. Friedman in the 1950s and has
been used as a standard reference to assess whether a labor is progressing normally.
According to the curve, labor is considered "prolonged" if it deviates significantly from the
expected rate of cervical dilation and descent.
New Research and Normal Labor Duration
As mentioned in your statement, there is ongoing research suggesting that the traditional
understanding of normal labor duration may need to be reconsidered. The study you mentioned
(Zhang, Landy, Branch, et al., 2010) likely contributed to this reevaluation. This research and
other studies have highlighted that the duration of labor can vary widely among women, and a
longer duration may still result in a healthy outcome for both mother and baby, as long as
progress is being made.

Explanation
This shift in understanding reflects the importance of individualized care in labor and the
recognition that deviations from the Friedman curve may not necessarily indicate a problem if
the overall health of the mother and baby is being monitored and maintained.
It's important to note that the management of labor and the determination of what is considered
"normal" can vary among healthcare providers and institutions. Decisions regarding labor
management should always be made in consultation with a qualified healthcare provider who
considers the unique circumstances of each pregnancy and labor.
Latent Phase
the latent or early phase of labor, which begins with mild contractions and ends when rapid
cervical dilation begins. Multiparous individuals progress faster through this phase, while a
"nonripe" cervix may lengthen it. Analgesia can be given if desired but may prolong the phase if
administered too early. Psychological readiness and relaxation help manage discomfort.
Encouraging activity and preparation, as well as alternative pain relief methods, are suggested
during this phase, emphasizing the importance of individualized support.
Active Phase
The active phase of labor is characterized by a faster rate of cervical dilation, stronger and
longer contractions occurring every 3 to 5 minutes, and the possibility of increased vaginal
secretions and spontaneous membrane rupture. Women are encouraged to stay active and find
comfortable positions during this phase, except for lying flat on their back. This phase can be
challenging due to the intensified contractions, leading to increased discomfort. Emotionally, it's
a mix of excitement and anxiety as the birthing individual prepares for the imminent arrival of
their baby, recognizing the life-changing event ahead.
Transition Phase
In this phase, a woman may experience intense discomfort, possibly leading to nausea and
vomiting. She might feel a loss of control, anxiety, panic, and irritability. The strength and
duration of contractions can make it seem like labor has taken over. Physical comfort measures,
such as wiping the forehead or back rubs, may no longer be welcome as her focus shifts
entirely to the birthing process. Near the end of this stage, around 10 cm dilatation, unless she
has received epidural anesthesia, she often feels the irresistible urge to push.
Labor Support
Labor support can be the father of the baby, a partner, a family member, a birth assistant (doula)
or a clinical caregiver.
Explanation
Labor support persons take on many roles during labor. They can provide support by helping
the laboring woman into positions of comfort, helping her on and off the birth ball or peanut ball
(described later), providing massage, offering companionship, helping her breathe through her
contractions, giving her ice chips, and verbally encouraging and reassuring her through each
contraction.

 Relaxation – physical and mental

 Creating a soothing environment
 Hypnobirthing
 Hydrotherapy
 Touch therapy
 Movement and positioning
 Breathing
Explanation
A woman in labor has a variety of non-pharmacological techniques for decreasing pain. She has
to choose what techniques feel good for her in labor. While a variety of techniques may be used,
she may change how and when she uses them based on her labor scenario. Having positive
and involved labor support as well as supportive caregivers will enhance her birth experience.
https://my.clevelandclinic.org/health/articles/15586-labor-without-medication-coping-skills