6 Is The New 4

In March of 2014, ACOG released a consensus statement:

Safe Prevention of the Primary Cesarean Delivery

In this consensus statement, which was released in effort to lower the United State’s Cesarean Rate, ACOG redefined “normal” labor progress. In a stunning realization ACOG announced that dilation from 4 cm to 6 cm could take 4-6 hours longer than Friedman’s Curve suggested.

ACOG defined 6 cm as the threshold for the active phase of labor. It’s important to understand this new threshold strictly applies to the clinical management of labor and not the timing of admission to hospital or the frequency and intensity of contractions.


Read more:

ACOG Consensus Statement: Safe Prevention of the Primary Cesarean

So, what does that mean for you as a consumer??

It means that 

cesarean deliveries for failed induction of labor in the latent phase can be avoided by allowing longer durations of the latent phase (up to 24 hours or longer)

Emphasis added: I digress to urge you, all of you, to rethink this concept of “allowing” women in labor.

 Birth Monopoly | You're Not Allowed to Not Allow Me

Birth Monopoly | You’re Not Allowed to Not Allow Me


It means that the average labor and second stage (pushing) may take a lot longer than doctors and hospitals have been anticipating.

It means that

Cesarean delivery for active phase arrest in the first stage of labor should be reserved for women at or beyond 6 cm of dilation with ruptured membranes who fail to progress despite 4 hours of adequate uterine activity, or at least 6 hours of oxytocin administration with inadequate uterine activity and no cervical change.

It requires that care providers have advanced practical skills and suggests that

Amnioinfusion for repetitive variable fetal heart rate decelerations may safely reduce the rate of cesarean delivery.

It means that

Before 41 0/7 weeks of gestation, induction of labor generally should be performed based on maternal and fetal medical indications. 

Read in detail, recommendations for the safe prevention of the primary cesarean delivery.


Want to learn more? Have questions? Schedule your private consultation or contact me via

Guiding Angels Birth Services

Keep up to date with YC Birth Circle to join us for other great topics and visit my website to find a childbirth preparation course near you for a more in depth understanding of what we covered!


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