RT Journal Article SR Electronic T1 Changes in the management of labour: 1. Length and management of the second stage JF Canadian Medical Association Journal JO CMAJ FD Canadian Medical Association SP 1041 OP 1045 VO 136 IS 10 A1 J. L. Reynolds A1 P. L. Yudkin YR 1987 UL http://www.cmaj.ca/content/136/10/1041.abstract AB An analysis of 18,940 deliveries between 1981 and 1984 in a large British obstetric unit showed marked changes in the management of the second stage of labour. These changes included an increase in the length of the second stage (especially among primiparous women), a rise in the rate of spontaneous delivery and a large decline in the rate of episiotomy. There was no change in neonatal outcome or in the rate of maternal postpartum complications. These findings may have resulted from a more conservative approach to the management of the second stage. They may also reflect a better understanding among obstetric professionals of what constitutes a normal second stage and therefore better decisions about when to act and when to wait.