Abstract

Active management of labor (AML) is an approach to the supervision of primigravid labor developed during the past 30 years at the National Maternity Hospital, Dublin, Ireland.1 The approach represents a philosophy that is aimed at ensuring that as many women as possible achieve spontaneous vaginal birth with a minimum of appropriate intervention. The original intention of the approach was to decrease the incidence of prolonged labor.2 In recent times the approach has become associated with low cesarean rates,3,4 and this has stimulated considerable interest as a result of the rapid escalation in cesarean birth rates in developing countries over the past decade.5,6

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