In June 2015, the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) revised their position statement, Fetal Heart Monitoring. The position statement includes: “During the last decade, more evidence has emerged about normal labor progress and the influence of assessment of labor progress based on cervical status on route of birth. Previously held views about normal labor have been questioned, specifically the number of centimeters of cervical dilation that constitutes the beginning of active labor. Based on the cumulative body of evidence about normal labor progress, 6 centimeters rather than 4 centimeters dilation should be considered the beginning of the active phase of the first stage of labor . . . AWHONN supports the new recommendations, including the use of 6 centimeters dilation to define the beginning of the active phase of the first stage of labor, and has clarified suggestions for fetal assessment during labor in this context . . . In the absence of new data on frequency of fetal assessment associated with cervical dilation, AWHONN continues to recommend increasing the frequency of fetal assessment at 4 centimeters dilation.”
The position statement is available here for viewing prior to publication in an issue of the Journal of Obstetric, Gynecologic, & Neonatal Nursing.