Active Management of Labor
Some physicians routinely practice active management of labor to ensure that labor will be completed within 12 hours. The standard, which originated in Ireland, waits for the woman to be in active labor before initiating this practice. Once active labor is determined, the caregiver performs an amniotomy. If the woman does not progress 1 centimeter per hour, a high dose of Pitocin is started to augment labor. Another important component of this practice is to have a personal nurse provide continuous emotional support for the laboring woman.
Currently, many physicians use this technique, but employ it before active labor. Also, few women are fortunate enough to have a nurse provide continuous support throughout labor. If your physician actively manages labor, you may want to hire a doula to provide this important support. You may also want to discuss with him when he initiates this protocol. Or, you may choose not to have your labor actively managed, but rather, to allow labor to progress at its own pace.