Featured Committee Opinion

Approaches to Limit Intervention During Labor and Birth

Obstetrician–gynecologists, in collaboration with midwives, nurses, patients, and those who support them in labor, can help women meet their goals for labor and birth by using techniques that are associated with minimal interventions and high rates of patient satisfaction. Many common obstetric practices are of limited or uncertain benefit for low-risk women in spontaneous labor. For women who are in latent labor and are not admitted, a process of shared decision making is recommended. Admission during the latent phase of labor may be necessary for a variety of reasons. A pregnant woman with term premature rupture of membranes (also known as prelabor rupture of membranes) should be assessed, and the woman and her obstetrician–gynecologist or other obstetric care provider should make a plan for expectant management versus admission and induction. Data suggest that in women with normally progressing labor and no evidence of fetal compromise, routine amniotomy is not necessary. The widespread use of continuous electronic fetal heart-rate monitoring has not improved outcomes when used for women with low-risk pregnancies. Multiple nonpharmacologic and pharmacologic techniques can be used to help women cope with labor pain. Women in spontaneously progressing labor may not require routine continuous infusion of intravenous fluids. For most women, no one position needs to be mandated nor proscribed. Nulliparous women who have an epidural and no indication for expeditious delivery may be offered a period of rest for 1–2 hours before initiating pushing efforts. Obstetrician–gynecologists and other obstetric care providers should be familiar with and consider using low-interventional approaches for the intrapartum management of low-risk women in spontaneous labor.

PROLOG

Each of the 5 units of PROLOG addresses a major area in obstetrics and gynecology and consists of two parts—an assessment book and a critique book. Put your knowledge to the test and earn CME credits.

For purchasing information, please visit the Online Bookstore.

ACOG eModules

PROLOG eModules

ACOG eModules is an online self-evaluation and learning program. Each module offers testing, rich discussion, and CME.

www.acog.org/eModules

Coding Resources

Coding with ACOG

Learn how to code claims faster and more accurately with ACOG’s Coding Resources.

Coding Resources
Advertisement

American Congress of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188 | Mailing Address: PO Box 70620, Washington, DC 20024-9998