MAIN TEXT
Dr Emanuel Friedman in the 1950s introduced labor curve and defined the normal and abnormal labor1-3. His definitions of normal labor and abnormal labor are still widely accepted in current obstetric practices. The Friedman’s normal dilatation rate of 1cm/hr that is universally accepted is becoming questionable in our current obstetric population because of escalating rates of unnecessary labor interventions like oxytocin augmentation and caesarean section4,5. Recent studies also suggest that the active phase of labor does not start until 5-6 cm cervical dilatation has reached, and can be slower than it was historically described still women can achieve normal vaginal delivery6-9. There is also existing debate for this previously described labor pattern because of differences in race, ethnicity and difference in pelvic configuration10, 11. No study with such large sample size currently exists particularly for the South Asian population. The aim of our study is to compare labor pattern at 4cm and 6 cm cervical dilatation in spontaneous labor in low risk nulliparous women.