03/08/2026
Some of us have been observing, experiencing, and teaching about labor lulls/plateaus/pauses/whatever for a long time. I hope this study gets the attention it deserves, but I worry it won't since it doesn't fitvthe medical management narrative.
The review's authors questioned whether studies establishing norms for labor progress conducted at hospital births—where results would be affected by labor management policies and study participants experience varying degrees of medical intervention—represented true physiologic norms. To answer that question, they compiled the findings of 43 studies of midwives’ reports of non-linear labor progress, i.e., “labor slows, stalls, pauses, or even reverses, but later resumes naturally,” in which these phenomena were considered to be physiologic and normal. They found that such occurrences were common, could occur at any point in labor, lasted from a few minutes to more than two hours, and could occur multiple times in the same labor.
The midwife authors believed labor lulls to be not just normal but functional. They served purposes such as protecting against fetal distress and uterine muscle fatigue by allowing mother and baby to regulate the intensity of labor, permitting recovery from the demands of the dilation phase before embarking on the expulsion phase of labor, and permitting the baby to shift into a more favorable position for birth. One event, labor reversal, in which the cervix closes back down, they attributed to a reaction to interruptions or to agitation arising in the laboring woman or birthing person.
Regardless of whether lulls have the benefits claimed for them, these reports establish that obstetric expectations of how normal labor progresses don’t match reality and that, as the study concludes: “Research on physiological labor patterns, including plateaus, is a matter of some urgency as it is a necessary precursor to efforts aimed at reducing unnecessary and harmful interventions.”
https://bit.ly/4r1pa0B
