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Friedman’s Curve and Failure to Progress: A Leading Cause of Unplanned C-sections
Research and article by Hypnobabies mom, Rebecca Dekker, PhD, RN, APRN, who is a medical researcher and the author of Evidence Based Birth!
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“Failure to progress” is the number one reason for unplanned C-sections in the U.S.
Most women in labor are held to a standard called the “Friedman’s Curve.” Friedman’s curve is a graph that obstetric care providers have traditionally used to define a “normal” length and pace of labor. If a woman’s cervix does not dilate according to this schedule, she may be assigned a diagnosis of “failure to progress” and taken to the operating room for a Cesarean.
So what is this Friedman’s curve? When was it invented? Does it apply to women today?
In 1955, Dr. Friedman of Columbia University published a study describing the average amount of time it took women to dilate during labor (Friedman 1955). Until then, doctors had simply published research studies that described the total length of labor. Dr. Friedman went one step further by plotting women’s labors on a graph, and then figuring out the average length of time it took to a woman to dilate each centimeter. This graph became known as the famous “Friedman’s Curve.”Although it was published nearly 60 years ago, Friedman’s curve still serves as the basis of how most physicians define normal labor (Gabbe, Niebyl et al. 2012). In fact, as recently as 2010, researchers claimed that Friedman’s curve continues to “govern labor management.” In other words, most care providers use this graph to dictate how they manage a woman’s labor (Zhang, Troendle et al. 2010).You can see the rest of Rebeccca’s informative article HERE.