More than 50 years has elapsed since Dr. Friedman first introduced the standardized labor curve. Since that time there have been many changes in the manner in which health care is provided, the role of the nurse, and the characteristics of women in labor. The absence of clear and consistent guidelines for the diagnosis and management of the first stage of labor has resulted in confusion and controversy that has the potential to compromise quality of care and patient outcomes. Accurately determining each phase and stage of labor leads to appropriate intervention. This panel will present the challenges and strategies of navigating the course of the first stage of labor with a primary emphasis on the care of the nulliparous woman.