Simulation of labor: A study of the relationship between cesarean section rates and the time spent in labor

摘要

Cesarean delivery is the most common major abdominal surgery in many parts of the world. As of October 2012, the cesarean section rate in the United States was reported to be 32.8% in 2011, rising from 4.5% in 1970. Cesarean sections are associated with an increased risk of neonatal respiratory morbidity, increased risk of a hysterectomy and can cause major complications in subsequent pregnancies, such as uterine rupture. To evaluate the current cesarean delivery rate due to a “failure to progress” diagnosis, our goal was to replicate the delivery process for women undergoing a trial of labor. In this simulation we evaluate the Friedman Curve and other labor progression rules to identify circumstances in which the cesarean rate can be decreased through the analysis of the total length of time a woman spends in labor as well as the duration of time a woman remains in a cervical dilation stage.