{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:22:56Z","timestamp":1790036576117,"version":"4.0.1"},"reference-count":48,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2010,12,24]],"date-time":"2010-12-24T00:00:00Z","timestamp":1293148800000},"content-version":"vor","delay-in-days":169,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Midwife Womens Health"],"published-print":{"date-parts":[[2010,7,8]]},"abstract":"<jats:p><jats:bold>Introduction<\/jats:bold>: Laboring women are often admitted to labor units under criteria that are commonly associated with the onset of active\u2010phase labor (i.e., cervical dilatation of 3\u20135 cm in the presence of regular contractions). Beginning with these criteria through complete dilatation, this systematic review describes labor duration and cervical dilation rates among low\u2010risk, nulliparous women with spontaneous labor onset.<\/jats:p><jats:p><jats:bold>Methods<\/jats:bold>: Studies published in English (between 1990 and 2008) were identified via MEDLINE and CINAHL searches. Data were abstracted and weighted \u201cactive labor\u201d durations (i.e., from 3\u20135 cm through complete dilatation) and linear dilation rates were calculated.<\/jats:p><jats:p><jats:bold>Results<\/jats:bold>: Eighteen studies (n = 7009) reported mean \u201cactive labor\u201d duration. The weighted mean duration was 6.0 hours, and the calculated dilation rate was 1.2 cm per hour. These findings closely parallel those found at the median. At the statistical limits, the weighted \u201cactive labor\u201d duration was 13.4 hours (mean + 2 standard deviations) and the dilation rate was 0.6 cm per hour (mean \u2212 2 standard deviations).<\/jats:p><jats:p><jats:bold>Discussion<\/jats:bold>: These findings indicate that nulliparous women with spontaneous labor onset have longer \u201cactive\u201d labors and therefore slower dilation rates than are traditionally associated with active labor when commonly used criteria are applied as the starting point. Revision of existing active labor expectations and\/or criteria used to prospectively identify active phase onset is warranted.<\/jats:p>","DOI":"10.1016\/j.jmwh.2009.08.004","type":"journal-article","created":{"date-parts":[[2010,6,30]],"date-time":"2010-06-30T09:43:27Z","timestamp":1277891007000},"page":"308-318","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":81,"title":["\u201cActive Labor\u201d Duration and Dilation Rates Among Low\u2010Risk, Nulliparous Women With Spontaneous Labor Onset: A Systematic Review"],"prefix":"10.1111","volume":"55","author":[{"given":"Jeremy L.","family":"Neal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy K.","family":"Lowe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen L.","family":"Ahijevych","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thelma E.","family":"Patrick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori A.","family":"Cabbage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth J.","family":"Corwin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2010,12,24]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.obstetgynecol.2003.10.011"},{"key":"e_1_2_7_3_2","volume-title":"Williams obstetrics","author":"Cunningham FG","year":"2005"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2002.127142"},{"key":"e_1_2_7_5_2","first-page":"448","article-title":"Transition from latent to active labor","volume":"68","author":"Peisner DB","year":"1986","journal-title":"Obstet Gynecol"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(54)90311-7"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-195512000-00001"},{"key":"e_1_2_7_8_2","volume-title":"Labor: Clinical evaluation and management","author":"Friedman EA","year":"1978"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1969.tb05788.x"},{"key":"e_1_2_7_10_2","first-page":"179","article-title":"Computer analysis of labor progression. 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