Objective: To determine the effect of an active management of a labor program on the rate of cesarean section and labor outcomes in low-risk nulliparous pregnancies in a setting with limited resources. Material and Method: Nine hundred and seventy-five low risk nulliparous pregnant women were randomized to receive either active management of a labor program (n = 325) or conventional management (n = 650). The rate of cesarean section and labor outcomes were compared between the two groups using Chi-square and t-tests. Results: The subjects in the active management program had significantly shortened first stage of labor and total duration of labor compared with the conventional group (538.0 + 242.9 min vs 589.4 + 263.8 min, p < 0.05, 539.3 + 261.4 min vs 610.3 + 264.4 min, p < 0.001, respectively). There was no statistical difference found in the rate of cesarean section and other labor outcomes. Conclusion: The active management program shortened the first stage and duration of labor in low-risk nulliparous pregnant women