Proactive Support of Labor (2^nd Ed., Revised edition) The Challenge of Normal Childbirth

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. For peer and reader reviews of the first edition see: www.proactivesupportoflabor.com.

Foreword to the first edition; Preface; Dedication; Web-links; 1. General introduction; Part I. A Wake-up Call: 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; Part II. Back to Basics: 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; Part III. Proactive Support of Labor: 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; Index.

Paul Reuwer is Consultant Obstetrician-Gynecologist and Master of the Labor and Delivery Unit at St Elisabeth Hospital, Tilburg, The Netherlands.
Hein Bruinse is Chairman of the Dutch National Perinatal Audit Foundation, The Netherlands.
Arie Franx is Professor of Obstetrics and Chair of the Division of Woman and Baby, University Medical Centre Utrecht, The Netherlands.