Summary
A preoccupation with cephalopelvic disproportion is the main reason for a reluctance to abandon the conservative attitude towards labour which prevails in the United Kingdom and Ireland. In a series of 1000 consecutive primigravidae, in which an active approach to labour was adopted, the incidence of disproportion was less than 1 per cent and there was notable absence of trauma, especially to the child.
Oxytocin stimulation is recommended as an essential instrument to define disproportion when the natural forces are not adequate. Excessive caution is criticized because a diagnosis of disproportion cannot be made unless uterine action is adequate. It is concluded that the possibility of cephalopelvic disproportion does not justify a passive attitude towards labour in a modern maternity unit.