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Active management: a continuing benefit in nulliparous labor.

At the Tenth Birth Conference in Boston, 1992, a randomized clinical trial of active management of labor that is being conducted at Brigham and Women's Hospital in Boston was described by principal investigator, Fredric Frigoletto, Jr., MD. The study of 1800 primiparous women will examine the effect of the active management protocol on the rate of cesarean section. Since the presentation generated such strong disagreement during the discussion that followed, a further examination of the benefits and risks of the method is presented in this two-part roundtable. Part I comprises papers by Colm O'Herlihy, from National Maternity Hospital in Dublin where the active management of labor method originated, by Michael Klein, who moderated the Boston presentation and discussion, and by Henci Goer, who was an audience participant. Part II, to be published in the September issue, will contain papers by William Fraser, a Boston conference speaker who will discuss methodologic issues, by audience participant Karyn Kaufman presenting a midwife's perspective, by sociologist Barbara Katz Rothman, and by Marc J.N.C. Keirse, with a final comment.