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There is general agreement that a solution to the problem of dystocia would go a long way toward resolving the contentious issue of high cesarean birth rates that have become such a prominent feature of obstetric practice in recent years. At the National Maternity Hospital in Dublin, one of the largest obstetric units in Western Europe, this situation has been averted through a coordinated policy of early detection and effective treatment of abnormal uterine action over a period of 15 years. During 1980 the number of births was 8742, the incidence of cesarean section was 4.8%, and mothers were assured of delivery within 12 hours after admission to the labor unit. It is proposed that these results could be reproduced elsewhere.

(C) 1984 The American College of Obstetricians and Gynecologists