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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.