The 'stages' model of labour: deconstructing a myth

The current practice of dividing labour into stages is based on assumptions about the process of labour that conflict with current physiology. The ‘stages’ model is associated with arbitrary time limits placed on each stage of labour and is associated with an increase in the use of intervention. The requirement that midwifery practice is based on current best evidence conflicts with the adherence to the ‘stages’ model of labour. This article proposes an approach to labour that views it as a physiological process rather than an event. This approach would enable knowledge and understanding of physiology to inform decision making in labour. The ‘process’ approach to labour has the potential to enable care to be individualized. To accept this approach to labour, midwives need to become skilled in coping with uncertainty.