Striking a new balance between natural birth and intervention, and invariably enhancing women's satisfaction with the childbirth experience, the fully updated revision of this groundbreaking work will be essential reading for obstetricians, midwives, gynecologists and the like.
The right for every woman to have a 'natural' birth has been recognized for many years, yet surgical interventions continue to rise and, paradoxically, complaints and the degree of litigation for disappointing labor outcomes escalate.
Proactive Support of Labor enhances professional skills by providing the expertise for preventing long labors - the root-cause of traumatic birth experiences and the cesarean pandemic. Step-by-step, evidence-based guidance on expert care and support during labor is given. Emphasis is placed on pre-labor education, personal attention, and well-defined birth planning – including strict diagnoses and timely corrective measures in abnormal labor – and constant audit of all procedures and outcomes. Striking a new balance between natural birth and intervention, and invariably enhancing women's satisfaction with the childbirth experience, the fully updated revision of this groundbreaking work will be essential reading for obstetricians, midwives, nurses, and trainees.
The book has been released in the USA in 2010.
1. General introduction
2. Medical excess in normal childbirth
3. Avoidable causes of failed labors
4. Harmful birth care practices
5. Destructive territorial disputes
6. Self-sustaining mechanisms
7. Forgotten lessons from nature
8. Elementary biophysics of birth
9. Definitions and verbal precision
10. First-stage labor revisited
11. Second-stage labor redefined
12. Leading principles
13. Nulliparous versus parous labor
14. Diagnosis of labor
15. Prevention of long labor
16. Personal attention and support
17. Amniotomy and oxytocin
18. Pre-labor preparation
19. Affective dimensions of labor pain
20. Pain relief re-examined
21. Dynamic dystocia unraveled
22. Obstructed labor
23. Curtailed use of induction
24. Safe care of the fetus
25. Organizational reforms
26. Implementation and ongoing audit cycle
27. External audit of procedures and outcomes
The central message remains unchanged in the updated Second Edition of this book and continues to emphasize the need for fundamental reforms in the world of obstetrics and midwifery. The policy proposals – aimed at enhancement of women’s satisfaction with the childbirth experience and a safe reduction of the cesarean birth rate – stay the same.
New is the deeply researched treatise on the worrying misapplication of Evidence Based Medicine, leading to false evidence claiming a tempering effect of labor inductions on cesarean rates. Many other prevalent misinterpretations of the literature are exhibited, and several new examples of disturbing misguidance from official guidelines are exposed.
The chapters on audit and quality control have been rewritten. The clinical procedures and outcomes are now analyzed according to the Robson ten-group classification system, providing the best evidence of the effectiveness and safety of the combined policies and the overall strategy of proactive support of labor.
Proactive Support of Labor is a carefully orchestrated and audited team approach involving the laboring woman, nurse, midwife, and obstetrician committed to a safe and normal delivery. Its disciplined, evidence-based policies provide the expertise for adequate labor support, both emotionally and technically, effectively preventing protracted labors and traumatic deliveries. Unnecessarily long and insufficiently supported labor is the root-cause of avoidable operative delivery and a womans dissatisfaction with the childbirth experience.