**3. Second stage of labor**

## **3.1 Current definition of duration of the second stage of labor**

The duration of the second stage of labor can vary among individuals and is influenced by several factors. The second stage of labor begins when the cervix is fully dilated and usually last about 50 minutes in nulliparas and 20 minutes in multiparas, however, is increased in duration in patients with epidural analgesia [10]. In 2014, an obstetric care consensus recommended following a specific maximum length to avoid prematurely performing a cesarean delivery: nulliparous with an epidural up to 4 hours, nulliparous without an epidural up to 3 hours, multiparous with an epidural up to 3 hours, and multiparous without an epidural up to 2 hours [4].
