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Evidence LibraryCesarean deliveryReasons for cesarean
Evidence Library · Reasons for cesarean

Labor that does not progress

The definition changed in 2014, and many clinicians still use the old one.

This is the single largest reason first cesareans are performed. Active labor now begins at 6 cm, not 4, and arrest should not be diagnosed before 6 cm with ruptured membranes plus at least 4 hours of adequate contractions or 6 hours of oxytocin without change. Many clinicians still apply the older, faster standard.

Where this comes from:
182. Caughey AB, Cahill AG, Guise JM, Rouse DJ. Safe prevention of the primary cesarean delivery. Obstetric Care Consensus No. 1. Obstet Gynecol. 2014;123(3):693-711. Withdrawn; replaced by ACOG Clinical Practice Guideline No. 8, Obstet Gynecol. 2024;143(1):144-162.
183. Zhang J, Landy HJ, Ware Branch D, Burkman R, Haberman S, Gregory KD, et al. Contemporary patterns of spontaneous labor with normal neonatal outcomes. Obstet Gynecol. 2010;116(6):1281-1287.

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