Normal Length of Labor

There have been a number of careful studies on the normal length of labor, and, as in most such studies of large groups, there are many cases which do not approximate the average findings. In my own experience I can recall two dramatic dissenters, women who actually had their babies with the first pain. I shall recite the case history of one.

During my residency one of the senior staff members sent a patient into the hospital a few days before her expected date of confinement. He told me that she was a most unusual lady, like the Hebrew women in Exodus—’Lively, and are delivered ere the midwives come.’ He had been engaged as accoucheur on the three previous occasions, but had never once even caught up with the stork. This time, however, he was obstinately determined to win from his feathered colleague, and he asked me to call him early in her labor. At 2:20 A.M. the nurse telephoned me. She said the patient had awakened; she had had no pains, but felt queer. With fire-manlike haste I leapt into a pair of pants and dashed. As I arrived on the delivery floor, I collided with the stork, who was zooming down in a daredevil landing. After encasing my unwashed hands in sterile rubber gloves, I received the child, born after a single pain. It was all over by 2:31. There was no point in notifying the senior doctor until the next morning, but I immediately went to the telephone and called the husband. His only response was, ‘Why in the hell can’t you fools ever call me in time?’ With commendable restraint, I slammed down the receiver.

This extreme example should fill the reader with neither apprehension nor false expectancy, since no first babies and very few subsequent babies are born after the first few pains. One of the staff of the Johns Hopkins Hospital published an analysis of the total length of labor in 10,000 deliveries—that is, from the onset of the first pain until the whole process is over, including the extrusion of the afterbirth. He reported three values: mean, median, and mode. Mean is average. Median is the central value; that is, exactly as many women had labors longer as had labors shorter than the median figure listed below. The modal value is the commonest value observed, the precise duration of labor most frequent in the total series. The researcher divided his patients into primipara (first labors) and multipara (all labors subsequent to the first):

Mean (Hours) Median (Hours) Mode (Hours)

Primipara 13.04 10.59 7.

Multipara 8.15 6.21 4.

It is generally agreed that median and modal values in a study of this type are more significant than mean values.

Several investigators have reported on the incidence of very rapid labors—labors lasting less than three hours—and relatively long labors—those requiring more than twenty-four hours. One woman in a hundred may anticipate that her first child will be born in less than three hours, and seven in a hundred may expect such good fortune in subsequent births. Approximately every ninth woman requires more than twenty-four hours to deliver a first child, and every thirty-third, children subsequent to the first.