Incidence, management and outcomes of prolonged second stage of labour in a rural setting in Malawi: a retrospective cohort study

Prolonged second stage of labour was relatively common, and perhaps under-diagnosed due to a very sizeable proportion of women arriving whilst already in the second stage, of whom most gave birth spontaneously. Caesarean section occurred twice as often as vacuum extraction, suggesting a role for additional training and decision-making during childbirth to support the use of vacuum extraction.