BMJ 1994;309:1015 (15 October)

Letters

Active management of labour

True purpose has been misunderstood

EDITOR,--I wish to dispel any misunderstanding that may have arisen concerning the true purpose of active management of labour,1 introduced in the BMJ in 1969.2 The purpose is to enhance the experience of childbirth for mothers, particularly first time mothers, whose need is greatest.3 The result has been that every expectant mother who attended this hospital during the past 25 years about 150000--was given two firm assurances: that labour would not last longer than 12 hours and that a sympathetic nurse-midwife would afford personal attention throughout. The rate of caesarean section was not a motivating factor.

Rates of caesarean section did not become an issue until much later, and in a different context. In 1969 there were no substantial differences among institutions in Britain or between the two sides of the Atlantic; rates rarely exceed 5% (of total births). Through the 1970s a fourfold increase . . . [Full text of this article]


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Relevant Article

Active management of labour: current knowledge and research issues
J G Thornton and R J Lilford
BMJ 1994 309: 366-9. [Abstract] [Full Text]

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