This patient has had 3 previous pregnancies but has never given live birth. Therefore, she is considered to be nulliparous. A nulliparous woman is considered to have a prolonged second stage of labor if it lasts longer than 2 hours without an epidural. Therefore, at 2 hours the nurse would notify the provider of a prolonged second stage of labor. If she had an epidural, the second stage of labor would be considered prolonged at 3 hours. 1 hour is not considered prolonged and waiting for 4 hours is too long.