PROACTIVE SUPPORT OF LABOR. THE CHALLENGE OF NORMAL CHILDBIRTH. 2ND EDITION

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.

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.

Features
• A deeply researched analysis of the ills and challenges of current obstetrics and midwifery, debunking fallacies from the misapplication of EBM - an eye-opener for many birth professionals and pregnant women
• An in-depth reinterpretation of the basic biophysics dominating the natural process of birth - revaluates the basic science of parturition, reinstating real, evidence-based practice
• A step-by-step exposition of all medical and non-medical components of a safe, simple, and high-quality childbirth system, supported by the best possible clinical evidence - introduces a safe, simple, and high quality birth-plan, universally applicable; promotes a spontaneous, safe and rewarding labor and delivery; and greatly improves women's satisfaction with the childbirth experience

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