title: How Long Is a Normal Labor? Contemporary Patterns of Labor and Birth in a Low-Risk Sample of 1,612 Women from Four Nordic Countries.
abstract: OBJECTIVE
  Normal progress of labor is a subject for discussion among professionals. The aim of this study was to assess the duration of labor in women with a planned home birth and spontaneous onset who gave birth at home or in hospital after transfer.
  
  
  METHODS
  This is a population-based study of home births in four Nordic countries (Denmark, Iceland, Norway, and Sweden). All midwives assisting at a home birth from 2008 to 2013 were asked to provide information about home births using a questionnaire.
  
  
  RESULTS
  Birth data from 1,612 women, from Denmark (n = 1,170), Norway (n = 263), Sweden (n = 138), and Iceland (n = 41) were included. The total median duration from onset of labor until the birth of the baby was approximately 14 hours for primiparas and 7.25 hours for multiparas. The duration of the different phases varied between countries. Blood loss more than 1,000 mL and perineal ruptures that needed suturing were associated with a longer pushing phase and the latter with country of residence, parity, single status, and the baby's weight.
  
  
  CONCLUSIONS
  In this population of healthy women with a low prevalence of interventions, the total duration of labor was fairly similar to what is described in the literature for multiparas, but longer for primiparas. Although the duration of the phases of labor differed among countries, it was to a minor extent associated with severe outcomes.
authors.affiliation: Department of Nursing, Mid Sweden University, Sundsvall, Sweden.|Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Ingegerd
authors.initials: I
authors.lastname: Hildingsson
authors.affiliation: Faculty of Health Sciences, Research Group: Maternal, Reproductive and Children's Health, Oslo, Norway.|Akershus University College of Applied Sciences, Oslo, Norway.
authors.forename: Ellen
authors.initials: E
authors.lastname: Blix
authors.affiliation: The Research Unit, Women's and Children's Health, The Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: Hanne
authors.initials: H
authors.lastname: Hegaard
authors.affiliation: Unit for Clinical Genetics, Oslo University Hospital, Oslo, Norway.
authors.forename: Anette
authors.initials: A
authors.lastname: Huitfeldt
authors.affiliation: Region Sealand Homebirth Association, Sorø, Denmark.
authors.forename: Karen
authors.initials: K
authors.lastname: Ingversen
authors.affiliation: Faculty of Nursing, Department of Midwifery, University of Iceland, Reykjavík, Iceland.
authors.forename: Ólof Ásta
authors.initials: ÓÁ
authors.lastname: Ólafsdóttír
authors.affiliation: Department of Women's and Children's Health, Division of Reproductive Health, Karolinska Institutet, Stockholm, Sweden.|Department of Health and Care Science, Sahlgrenska Akademin, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Helena
authors.initials: H
authors.lastname: Lindgren
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006700:Home Childbirth / Q000009:adverse effects / Q000706:statistics & numerical data; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D008880:Midwifery / Q000379:methods / Q000706:statistics & numerical data; D009664:Norway / Q000453:epidemiology; D007744:Obstetric Labor Complications / Q000453:epidemiology / Q000209:etiology; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors
keywords: country of birth; duration of labor; home birth; phases of labor; physiological birth