Emanuel A. Friedman M.D. introduced the Friedman Curve in 1955. In a recently submitted article written by Michigan lawyers Jesse M. Reiter and Emily G. Thomas, the authors and stalwarts of the Birth Trauma Litigation Group write that the gold standard for assessing the normal and abnormal progress of labor was changed in 2014. The change by the American College of Obstetrics and Gynecology (ACOG) replaced Friedman’s curve with new labor standards.
The purpose of the Friedman Curve was to assess labor progression and to identify whether the mother had a “reduced likelihood of a safe vaginal delivery.” When there was an abnormal progress of labor, such as when neonatal morbidity and mortality were greatly increased, the analysis called on obstetricians to decide very quickly to rescue the unborn baby.
According to the Friedman papers, an “arrest of dilation” was diagnosed by documenting the lack of dilation progress in the active phase of labor. “Protracted active-phase” dilation was defined to be 1.2 cm per hour or 1.5 cm per hour where there was more than one fetus to be delivered. According to the paper submitted by attorneys Reiter and Thomas, two vaginal examinations done by the same individuals spaced two hours apart was good enough to make this diagnosis. If the cervix did not dilate according to the maximal slope on Friedman’s curve over two hours, the patient was diagnosed with failure to progress/arrest of labor and delivered by Cesarean delivery. Cesarean delivery was then recommended to avoid neonatal death or catastrophic injury. Many studies over the 60 years showed that the research supported the Friedman Curve.