Strength of this project is the understanding why some dystocic deliveries, despite adequate stimulation with oxytocin, do not reach a spontaneous vaginal delivery. It is also a strength that clinics from various settings are included, which makes it possible to confirm that the method of AFL is easy to use, irrespective of geography, culture or clinic size. Some limitations of the study should be noted. As it was not feasible to change clinical guidelines simply for this observational study. Different methods of managing arrested labors were seen in the clinics included, even though the same inclusion criteria were used for the study. The number of deliveries eligible to be included was also limited, due to the strict inclusion criteria: all women included had to be healthy nullipara with a spontaneous onset of labor, in order to avoid bias and interference factors.