Table 2.
Percentage of women delivering by spontaneous vaginal birth without serious morbidity or mortality vs. percentage of women delivering with any serious morbidity or mortality by half hour intervals, among women that have not delivered by the beginning of the interval, stratified by parity and epidural status.*
| Nulliparous With Epidural | Nulliparous Without Epidural | Multiparous With Epidural | Multiparous Without Epidural | |||||
|---|---|---|---|---|---|---|---|---|
| Duration of 2nd Stage (hours) | Spontaneous Vaginal Birth without Morbidity (%) | Birth with Composite Maternal or Neonatal Morbidity or mortality† (%) | Spontaneous Vaginal Birth without Morbidity (%) | Birth with Composite Maternal or Neonatal Morbidity or mortality† (%) | Spontaneous Vaginal Birth without Morbidity (%) | Birth with Composite Maternal or Neonatal Morbidity or mortality† (%) | Spontaneous Vaginal Birth without Morbidity (%) | Birth with Composite Maternal or Neonatal Morbidity or mortality† (%) |
| 0 to 0.5 | 15.6 | 1.6 | 34.1 | 2.6 | 60.1 | 6.0 | 73.4 | 5.0 |
| >0.5 to 1.0 | 25.2 | 3.1 | 36.0 | 2.9 | 50.9 | 5.2 | 50.4 | 3.6 |
| >1.0 to 1.5 | 25.0 | 3.6 | 30.3 | 3.6 | 38.1 | 4.2 | 37.4 | 2.8 |
| >1.5 to 2.0 | 24.3 | 4.2 | 26.7 | 4.0 | 33.3 | 3.3 | 33.7 | 2.7 |
| >2.0 to 2.5 | 23.5 | 4.0 | 25.0 | 2.4 | 29.6 | 3.1 | 29.8 | 2.4 |
| >2.5 to 3.0 | 21.7 | 4.5 | 23.9 | 3.9 | 25.1 | 2.9 | 28.8 | 3.9 |
| >3.0 to 3.5 | 19.5 | 4.4 | 17.2 | 4.1 | 23.1 | 3.4 | 24.8 | 1.6 |
| >3.5 to 4.0 | 18.6 | 5.0 | 22.4 | 4.2 | 21.6 | 3.2 | 22.4 | 2.2 |
| >4.0 to 4.5 | 16.3 | 5.6 | 15.2 | 1.4 | 22.8 | 4.8 | 15.4 | 0 |
| >4.5 to 5.0 | 13.4 | 4.5 | 16.7 | 5.3 | 18.0 | 2.5 | 14.5 | 2.1 |
| >5.0 to 5.5 | 12.3 | 3.8 | 9.5 | 2.1 | 18.0 | 1.9 | 15.6 | 2.6 |
| >5.5 to 6.0 | 12.5 | 4.6 | 5.5 | 1.4 | 22.6 | 2.5 | 73.4 | 5.0 |
For example, for nulliparous women with epidural, given that a woman had not delivered in 3 hours, her likelihood of delivering with any serious morbidity or mortality in the next half hour was 4.4% compared to her likelihood of delivering by spontaneous vaginal birth without serious morbidity or mortality was 19.5%.
Delivery by any mode; composite maternal morbidity or mortality included postpartum hemorrhage, blood transfusion, cesarean hysterectomy, endometritis, intensive care unit admission or death. Composite neonatal morbidity or mortality included shoulder dystocia with fetal injury (clavicular fracture, Erb’s palsy, Klumpke’s palsy or hypoxic-ischemic encephalopathy), 5-minute Apgar < 4, need for continuous positive airway pressure resuscitation or higher, NICU admission, sepsis, pneumonia, hypoxic-ischemic encephalopathy or periventricular leukomalacia, seizure, intracranial hemorrhage or periventricular hemorrhage, asphyxia, or neonatal death.