Nanna Maaløe and colleagues argue that resource challenges, unclear and outdated clinical practice guidelines, and lack of women’s perspectives lead to overdiagnosis and overtreatment of prolonged labour
Prolonged labour results in considerable morbidity and mortality globally in women and children, as well as risk of caesarean section, uterine rupture, and fetal adverse events.1 In some instances, labour fails to progress because of fetal malposition or disproportion between the fetus and the woman’s pelvis. However, the commonest cause of prolonged labour is inefficient uterine contractions (fig 1).2 For women with weak uterine contractions, synthetic oxytocin may increase the power of contractions, but there are associated risks, including hyperstimulation, stillbirth, and neonatal complications. 45678910 Furthermore, caesarean section may still be required, and evidence that synthetic oxytocin reduces the risk of caesarean section is scarce.56 Adding to the challenge, defini