The length of the second stage of labor in uncomplicated, nulliparous African American and Puerto Rican women.

The Friedman Curve of Normal Labor, based on Emanuel Friedman's studies of Caucasian women in 1954 and 1955, remains the "gold standard" for assessing progress in the second stage of labor. Clinical observation by the authors, however, suggests that the second stage of labor is shorter in African American and Puerto Rican women. This descriptive, comparative study examined the duration of the second stage of labor in nulliparous African American and Puerto Rican women with uncomplicated births. The labor and delivery records of 373 African American and 157 Puerto Rican nulliparous women were randomly selected and reviewed, and the mean durations of the second stage of labor for both groups were compared to Friedman's labor curve. The mean length of second stage of labor in the sample of African American women was 31.6 minutes with a standard deviation of +/- 22.5 minutes, significantly shorter than Friedman's duration (P < .01). The mean length of second stage of labor in the sample of Puerto Rican women was 44.32 minutes with a standard deviation of +/- 33.03 minutes. This was also shorter than Friedman's figure for the second stage of labor (P < .01). These findings provide a more appropriate curve for monitoring labor progress in women from different ethnic backgrounds.

Station in early labor in nulliparous women at term.

Several authors of standard obstetric texts state that engagement occurs before the onset of labor in a majority of nulliparas at term, and failure of the fetal head to engage in early labor is a greater indicator for operative birth. A pilot clinical descriptive study was done at University Hospital, University of Medicine and Dentistry of New Jersey, in Newark to examine the birth outcomes of nulliparous women who arrived in early labor with an unengaged vertex presentation at term. For the study, 146 births were reviewed, and data from 101 vertex deliveries that met the study's criteria were compiled to test this hypothesis. The study results showed that in approximately 31% of the nulliparas, the fetal head was engaged. The incidence of the unengaged vertex in early labor in nulliparous women who met the study's criteria was found to be 69%. This factor alone did not predict birth outcome.