An evidence-based approach to the management of abnormal labour

Using three case studies, this article aims to discuss common problems occurring in labour and offers evidence-based management options. ‘Poor progress’ is the most common reason given for medical intervention in labour and yet it is not a diagnosis. Failure to recognise the variety of underlying causes leads to suboptimal care. Pyrexia in labour is a common occurrence with potentially very serious consequences, and a plan of care is suggested. Finally, it is clear that the use of epidural anaesthesia can negatively influence the process of ‘normal labour’ and strategies for limiting this are discussed.