Simkin's Labor Progress Handbook E-Book

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• Sprache: Englisch

Seitenzahl: 790

Veröffentlichungsjahr: 2023

Beschreibung

SIMKIN'S LABOR PROGRESS HANDBOOK Get ready to enhance your expertise in the world of childbirth with Simkin's Labor Progress Handbook -- a trusted resource tailored for childbirth medical practitioners This invaluable guide unravels the complexities of labor, equipping you with practical strategies to overcome challenges encountered along the way. Inside this comprehensive book, you'll discover a wealth of low-technology, evidence-based interventions designed to prevent and manage difficult or prolonged labors. Grounded in research and practical experience, these approaches are tailored by doulas and clinicians to provide optimal care and achieve successful outcomes. The fifth edition of this prestigious text includes information on: * Labor dystocia causes and early interventions and strategies promoting normal labor and birth * Application of fetal heart rate monitoring (intermittent auscultation, continuous electronic fetal monitoring, and wireless telemetry) while promoting movement and labor progress * The role of oxytocin and labor progress, and ethical considerations in oxytocin administration * Prolonged prelabor and latent first through fourth stage labor, addressing factors associated with dystocia * Positions, comfort measures and respectful care With meticulous referencing and clear, practical instructions throughout, Simkin's Labor Progress Handbook continues to be a timely and accessible guide for novices and experts alike, including doulas, nurses, midwives, physicians, and students.

Leseprobe

Simkin’s Labor Progress Handbook

Early Interventions to Prevent and Treat Dystocia

Fifth Edition

Edited By

Lisa Hanson

Klein Professor and Associate Director, Midwifery ProgramMarquette UniversityCollege of NursingMilwaukee, WI, USA

Emily Malloy

Certified Nurse MidwifeDirector of Midwifery ResearchMidwifery and Wellness CenterParticipating FacultyMarquette UniversityCollege of NursingMilwaukee, WI, USA

Penny Simkin

Certified Birth Doula and Certified Childbirth EducatorUSA

This edition first published 2024

© 2024 John Wiley & Sons Ltd

Edition History

Wiley-Blackwell (4e 2017)

Wiley-Blackwell (3e 2011)

Wiley-Blackwell (2e 2005)

Blackwell Science Limited (1e 2000)

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/permissions.

The right of Lisa Hanson, Emily Malloy, and Penny Simkin to be identified as the authors of the editorial material in this work has been asserted in accordance with law.

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The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting scientific method, diagnosis, or treatment by physicians for any particular patient. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. While the publisher and authors have used their best efforts in preparing this work, they make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives, written sales materials or promotional statements for this work. This work is sold with the understanding that the publisher is not engaged in rendering professional services. The advice and strategies contained herein may not be suitable for your situation. You should consult with a specialist where appropriate. The fact that an organization, website, or product is referred to in this work as a citation and/or potential source of further information does not mean that the publisher and authors endorse the information or services the organization, website, or product may provide or recommendations it may make. Further, readers should be aware that websites listed in this work may have changed or disappeared between when this work was written and when it is read. Neither the publisher nor authors shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

Library of Congress Cataloging-in-Publication Data

Names: Hanson, Lisa, 1958- editor. | Malloy, Emily, 1983- editor. | Simkin, Penny, 1938- editor.

Title: Simkin’s labor progress handbook : early interventions to prevent and treat dystocia / edited by Lisa Hanson, Professor and Director, Midwifery Program, Marquette University, USA, Emily Malloy, Penny Simkin.

Other titles: Labor progress handbook | Labor progress handbook

Description: Fifth edition. | Hoboken, NJ : John Wiley & Sons, 2024. | Revised edition of: Labor progress handbook / Penny Simkin, Lisa Hanson, Ruth Ancheta. Fourth edition. [2017]. | Includes bibliographical references and index.

Identifiers: LCCN 2023026403 (print) | LCCN 2023026404 (ebook) | ISBN 9781119754466 (paperback) | ISBN 9781119754428 (pdf) | ISBN 9781119754497 (epub)

Subjects: LCSH: Labor (Obstetrics)--Complications--Prevention--Handbooks, manuals, etc. | Birth injuries--Prevention--Handbooks, manuals, etc. | Shoulder dystocia--Prevention--Handbooks, manuals, etc.

Classification: LCC RG701 .S57 2024 (print) | LCC RG701 (ebook) | DDC 618.4--dc23/eng/20230623

LC record available at https://lccn.loc.gov/2023026403

LC ebook record available at https://lccn.loc.gov/2023026404

Cover Image: © RuslanDashinsky/Getty Images

Cover design by Wiley

Set in 9/11pt PlantinStd by Integra Software Services Pvt. Ltd, Pondicherry, India

Dedication

We dedicate this book to childbearing people, their families, and caregivers in the hope that some of the suggestions offered reduce the need for interventions and promote normal physiologic labor and birth. This book is named in honor of Penny Simkin, the original author, a leader innovator, activist, author, childbirth educator and doula.

Contents

Cover

Title Page

Copyright Page

Dedication

List of Contributors

Foreword

Chapter 1: Introduction

Causes and prevention of labor dystocia: a systematic approach

Notes on this book

Note from the authors on the use of gender-inclusive language

Conclusion

References

Chapter 2: Respectful Care

Health system conditions and constraints

LGBTQ birth care

RMC and pregnant people in larger bodies

Shared decision-making

Expectations

The impact of culture on the birth experience

Traumatic births

Trauma survivors and prevention of PTSD

Trauma-informed care as a universal precaution

Obstetric violence

Patient rights

Consent

Maternal mortality

References

Chapter 3: Normal Labor and Labor Dystocia: General Considerations

What is normal labor?

What is labor dystocia?

What is normal labor progress and what practices promote it?

Why does labor progress slow or stop?

Prostaglandins and hormonal influences on emotions and labor progress

Disruptions to the hormonal physiology of labor

Hormonal responses and gender

“Fight-or-flight” and “tend-and-befriend” responses to distress and fear during labor

Optimizing the environment for birth

The psycho-emotional state of the pregnant person: wellbeing or distress?

Pain versus suffering

Assessment of pain and coping

Emotional dystocia

Psycho-emotional measures to reduce suffering, fear, and anxiety

Before labor, what the caregiver can do

During labor: tips for caregivers and doulas, especially if meeting the laboring client for the first time in labor

Conclusion

References

Chapter 4: Assessing Progress in Labor

Before labor begins

Fetal presentation and position

Abdominal contour

Location of the point of maximum intensity (PMI) of the fetal heart tones via auscultation

Leopold’s maneuvers for identifying fetal presentation and position

Abdominal palpation using Leopold’s maneuvers

Estimating engagement:The rule of fifths

Malposition

Other assessments prior to labor

Estimating fetal weight

Assessing the cervix prior to labor

Assessing prelabor

Six ways to progress

Assessments during labor

Visual and verbal assessments

Hydration and nourishment

Psychology

Quality of contractions

Vital signs

Purple line

Assessing the fetus

Fetal movements

Gestational age

Meconium

Fetal heart rate (FHR)

Internal assessments

Vaginal examinations: indications and timing

Performing a vaginal examination during labor

Assessing the cervix

Assessing the presenting part

Identifying those fetuses likely to persist in an OP position throughout labor

The vagina and bony pelvis

Putting it all together

Assessing progress in the first stage

Features of normal latent phase

Features of normal active phase

Assessing progress in the second stage

Features of normal second stage

Conclusion

References

Chapter 5: Role of Physiologic and Pharmacologic Oxytocin in Labor Progress

History of oxytocin discovery and use in human labor

Structure and function of oxytocin

Oxytocin receptors

Oxytocin and spontaneous labor onset and progression

Promoting endogenous oxytocin function in spontaneous labor

Ethical considerations in oxytocin administration

Oxytocin use

Oxytocin use during latent phase labor

Oxytocin use during active phase labor

Oxytocin use during second stage labor

Changes in contemporary populations and labor progress

Oxytocin dosing

High dose/low dose

Variation in oxytocin dosing among special populations

Higher body mass index

Nullipara

Maternal age

Epidural

Problems associated with higher doses or longer oxytocin infusion

Postpartum hemorrhage

Fetal Intolerance to labor

Oxytocin holiday

Breastfeeding and beyond

New areas of oxytocin research

Conclusion

References

Chapter 6: Prolonged Prelabor and Latent First Stage

The onset of labor: key elements of recognition and response

Defining labor onset

Signs of impending labor

Prelabor

Prelabor vs labor: the dilemma

Delaying latent labor hospital admissions

Anticipatory guidance

Anticipatory guidance for coping prior in prelabor

Sommer’s NewYear’s Eve technique

Prolonged prelabor and the latent phase of labor

Fetal factors that may prolong early labor

Optimal fetal positioning: prenatal features

Miles circuit

Support measures for pregnant people who are at home in prelabor and the latent phase

Some reasons for excessive pain and duration of prelabor or the latent phase

Iatrogenic factors

Cervical factors

Management of cervical stenosis or the “zipper” cervix

Other soft tissue (ligaments, muscles, fascia) factors

Emotional dystocia

Troubleshooting Measures for Painful Prolonged Prelabor or Latent Phase

Measures to Alleviate Painful, Non-progressing, Non-dilating Contractions in Prelabor or Latent Phase

Synclitism and asynclitism

Open knee-chest position

Closed knee-chest position

Side-lying release

When progress in prelabor or latent phase remains inadequate

Therapeutic rest

Nipple stimulation

Membrane sweeping

Artificial rupture of membranes in latent labor

Can prenatal actions prevent some postdates pregnancies, prolonged prelabors, or early labors?

Prenatal preparation of the cervix for dilation

References

Chapter 7: Prolonged Active Phase

What is active labor? Description, definition, diagnosis

When is active labor prolonged or arrested?

Possible causes of prolonged active labor

Treatment of prolonged labor

Fetopelvic factors

How fetal malpositions and malpresentation delay labor progress

Determining fetopelvic relationships

Malpositions

Malpresentations

Use of ultrasound

Artificial rupture of the membranes (amniotomy) when there is a fetal malposition or malpresentation

Epidural analgesia and malposition or malpresentation

Maternal positions and movements for suspected malposition, malpresentation, or any “poor fit”

Overview and evidence

Positions to encourage optimal fetal positioning

Forward‐leaning positions

Side‐lying positions

Asymmetrical positions and movements

Abdominal lifting

“Walcher’s” position

Flying cowgirl

Low technology clinical approaches to alter fetal position

Digital or manual rotation of the fetal head

Digital rotation

Manual rotation

Early urge to push, cervical edema, and persistent cervical lip

Manual reduction of a persistent cervical lip

Reducing swelling of the cervix or anterior lip

Disruptions to the hormonal physiology of labor

Overview

If emotional dystocia is suspected

Predisposing factors theorized to contribute to emotional dystocia

Possible indicators of emotional dystocia during active labor

Measures to help cope with expressed fears

Hypocontractile uterine activity

Factors that can contribute to contractions of inadequate intensity and/or frequency

Immobility

Environmental and emotional factors

Uterine lactate production in long labors

Sodium bicarbonate

Calcium carbonate

When the cause of inadequate contractions is unknown

Breast stimulation

Walking and changes in position

Acupressure or acupuncture

Coping and comfort issues

Individual coping styles

Simkin’s 3 Rs: Relaxation, rhythm, and ritual: The essence of coping during the first stage of labor

Hydrotherapy: Warm water immersion or warm shower

Comfort measures for back pain

Exhaustion

Sterile water injections

Procedure for subcutaneous sterile water injections

Hydration and nutrition

Conclusion

References

Chapter 8: Prevention and Treatment of Prolonged Second Stage of Labor

Definitions of the second stage of labor

Phases of the second stage of labor

The latent phase of the second stage

Evidence-based support during the latent phase of second stage labor

What if the latent phase of the second stage persists?

The active phase of the second stage

Physiologic effects of prolonged breath‐holding and straining

Effects on the birth giver

Effects on the fetus

Spontaneous expulsive efforts

Diffuse pushing

Second stage time limits

Possible causes and physiologic solutions for second stage dystocia

Position changes and other strategies for suspected occiput posterior or persistent occiput transverse fetuses

The use of supine positions

Why not the supine position?

Use of the exaggerated lithotomy position

Differentiating between pushing positions and birth positions

Knees together pushing

Leaning forward while kneeling, standing, or sitting

Squatting positions

Asymmetrical positions

Lateral positions

Supported squat or “dangle” positions

Other strategies for malposition and back pain

Early interventions for suspected persistent asynclitism

Positions and movements for persistent asynclitism in second stage

Nuchal hand or hands at vertex delivery

If cephalopelvic disproportion or macrosomia (“poor fit”) is suspected

The influence of time on cephalopelvic disproportion

Fetal head descent

Verbal support of spontaneous bearing‐down efforts

Guiding the birthing person through crowning of the fetal head

Hand skills to protect the perineum

Perineal management during second stage

Topical anesthetic applied to the perineum

Intrapartum perineal massage

Waterbirth

Positions for suspected “cephalopelvic disproportion” (CPD) in second stage

Shoulder dystocia

Precautionary measures

Two step delivery of the fetal head

Warning signs

Shoulder dystocia maneuvers

The McRoberts’ maneuver

Suprapubic pressure

Hands and knees position, or the Gaskin maneuver

Shrug maneuver

Posterior axilla sling traction (PAST)

Tully’s FlipFLOP pneumonic

Somersault maneuver

Decreased contraction frequency and intensity

The essence of coping during the second stage of labor

If emotional dystocia is suspected

Triggers of emotional distress unique to the second stage

Conclusion

References

Chapter 9: Optimal Newborn Transition and Third and Fourth Stage Labor Management

Overview of the normal third and fourth stages of labor for unmedicated mother and baby

Third stage management: care of the baby

Oral and nasopharynx suctioning

Delayed clamping and cutting of the umbilical cord

Third stage management: the placenta

Physiologic (expectant) management of the third stage of labor

Active management of the third stage of labor

The fourth stage of labor

Baby‐friendly (breastfeeding) practices

Supporting microbial health of the infant

Routine newborn assessments

Conclusion

References

Chapter 10: Epidural and Other Forms of Neuraxial Analgesia for Labor: Review of Effects, with Emphasis on Preventing Dystocia

Introduction: analgesia and anesthesia—an integral part of maternity care in many countries

Neuraxial (epidural and spinal) analgesia—new terms for old approaches to labor pain?

Physiological adjustments that support maternal-fetal wellbeing

Multisystem effects of epidural analgesia on labor progress

The endocrine system

The musculoskeletal system

The genitourinary system

Can changes in labor management reduce problems of epidural analgesia?

Descent vaginal birth

Guided physiologic pushing with an epidural

Centering the pregnant person during labor

Conclusion

References

Chapter 11: Guide to Positions and Movements

Maternal positions and how they affect labor

Side‐lying positions

Pure side‐lying and semiprone (exaggerated Sims’)

The “semiprone lunge”

Side‐lying release

Sitting positions

Semisitting

Sitting upright

Sitting, leaning forward with support

Standing, leaning forward

Kneeling positions

Kneeling, leaning forward with support

Hands and knees

Open knee–chest position

Closed knee–chest position

Asymmetrical upright (standing, kneeling, sitting) positions

Squatting positions

Squatting

Supported squatting (“dangling”) positions

Half‐squatting, lunging, and swaying

Lap squatting

Supine positions

Supine

Sheet “pull‐to‐push”

Exaggerated lithotomy (McRoberts’ position)

Maternal movements in first and second stages

Pelvic rocking (also called pelvic tilt) and other movements of the pelvis

Hip sifting

Flexion of hips and knees in hands and knees position

The lunge

Walking or stair climbing

Slow dancing

Abdominal lifting

Abdominal jiggling with a shawl

The pelvic press

Other rhythmic movements

References

Chapter 12: Guide to Comfort Measures

Introduction: the state of the science regarding non‐pharmacologic, complementary, and alternative methods to relieve labor pain

General guidelines for comfort during a slow labor

Non‐pharmacologic physical comfort measures

Heat

Cold

Hydrotherapy

How to monitor the fetus in or around water

Touch and massage

How to give simple brief massages for shoulders and back, hands, and feet

Acupuncture

Acupressure

Continuous labor support from a doula, nurse, or midwife

How the doula helps

What about staff nurses and midwives as labor support providers?

Assessing the laboring person’s emotional state

Techniques and devices to reduce back pain

Counterpressure

The double hip squeeze

The knee press

Cook’s counterpressure technique No. 1: ischial tuberosities (IT)

Cook’s counterpressure technique No. 2: perilabial pressure

Techniques and devices to reduce back pain

Cold and heat

Cold and rolling cold

Warm compresses

Maternal movement and positions

Birth ball

Transcutaneous electrical nerve stimulation (TENS)

Sterile water injections for back labor

Procedure for subcutaneous sterile water injections

Breathing for relaxation and a sense of mastery

Simple breathing rhythms to teach on the spot in labor

Bearing‐down techniques for the second stage

Spontaneous bearing down (pushing)

Self‐directed pushing

Conclusion

References

Index

End User License Agreement

List of Tables

CHAPTER 03

Table 3.1. Definitions of Normal Labor...

Table 3.2. Etiologies and risk factors...

Table 3.3. Major hormones of pregnancy...

CHAPTER 04

Table 4.1. Fetal positions—abdominal...

Table 4.3. The original Bishop Score...

Table 4.4. Three‐tiered fetal...

Table 4.5. Interpretation of auscultation...

Table 4.6. Fetal positions viewed from...

CHAPTER 05

Table 5.1. Key considerations and...

Table 5.2. Adjusted median duration...

Table 5.3. Clinical guidance for use...

CHAPTER 06

Table 6.1. Self-administered techniques...

Table 6.1. Alternative and complementary...

CHAPTER 07

Table 7.1. Scientific evidence...

CHAPTER 08

Table 8.1. The Ottawa Hospital...

Table 8.2. Difference between...

Table 8.3. Shoulder dystocia...

CHAPTER 09

Table 9.1. Ten steps to successful...

Table 9.2. Microbiome glossary.

Table 9.3. Microbe-challenging...

List of Illustrations

CHAPTER 01

Chart 1.1. Care plan for the problem...

CHAPTER 02

Fig. 2.1a. Placement of Novii monitor.

Fig. 2.1b. Pregnant person in...

CHAPTER 03

Fig. 3.1. Physiological and psychological...

Fig. 3.2. Coping from Roberts...

Fig. 3.3. Not coping from Roberts...

CHAPTER 04

Fig. 4.4. Abdominal contour with...

Fig. 4.5. Abdominal contour with...

Fig. 4.6. (a) Using a Pinard...

Fig. 4.7. Location of fetal heart...

Fig. 4.8. Leopold’s first maneuver.

Fig. 4.9. Leopold’s second maneuver.

Fig. 4.10. Leopold’s third maneuver.

Fig. 4.11. Leopold’s fourth maneuver.

Fig. 4.12. Assessing fetal descent...

Fig. 4.B1. “Pie” map form.

Fig. 4.B2. Example of a belly map.

Fig. 4.B3. Using a doll to explain...

Fig. 4.B4. Left occiput anterior...

Fig. 4.B5. Right occiput posterior...

Fig. 4.13. Using the Pinard...

Fig. 4.14. Slow dancing with...

Fig. 4.15. Partner holding...

Fig. 4.16. Monitoring with...

Fig. 4.17. Monitoring out...

Fig. 4.18. (a) Walking with...

Fig. 4.19. Using wireless telemetry...

Fig. 4.20. Using wireless telemetry...

Fig. 4.21. (a) Supine position...

Fig. 4.22. Stations of descent.

Fig. 4.23. Finding the ischial...

Fig. 4.24. Vaginal examinations...

Fig. 4.25. Landmarks on the occiput...

Fig. 4.26. Occiput transverse fetal...

Fig. 4.28. Asynclitic fetus in right...

CHAPTER 06

Fig. 6.1. Helpful positions...

Chart 6.1. Prolonged prelabor...

Fig. 6.2. Miles circuit. (a)...

Fig. 6.3. Right occiput posterior...

Fig. 6.4. (a) Posterior asynclitism...

Fig. 6.5. Synclitism.

Fig. 6.6. Kneeling with a ball...

Fig. 6.7. Standing, leaning forward...

Fig. 6.8. Straddling a chair.

Fig. 6.9. (a) Pregnant person with poor...

Fig. 6.10. (a) Abdominal lifting. (b) Abdominal...

Fig. 6.11. (a) Open knee–chest...

Fig. 6.12. Closed knee–chest...

Fig. 6.13. Side-lying Release.

CHAPTER 07

Fig. 7.1. Right occiput...

Fig. 7.2. Left occiput...

Fig. 7.3. Posterior asynclitism.

Fig. 7.4. Anterior asynclitism.

Fig. 7.5. Synclitism.

Fig. 7.6. Forward learning...

Fig. 7.7. Pregnant person...

Fig. 7.8. Pregnant person...

Fig. 7.9. Pregnant person...

Fig. 7.10. (a) Semiprone lunge...

Fig. 7.11. (a) Standing with...

Fig. 7.12. (a) Standing...

Fig. 7.13. (a) Abdominal...

Fig. 7.14. Walcher’s (a) With...

Fig. 7.15. Flying cowgirl.

Fig. 7.16. Digital rotation.

Fig. 7.17. Manual rotation.

Fig. 7.18. (a) Hands and knees. (b) Kneeling...

Fig. 7.19. Semiprone (exaggerated...

Fig. 7.20. (a) Open knee–chest...

Fig. 7.21. (a) Hands and knees. (b) Kneeling...

Fig. 7.22. (a) Side-lying. (b) Semiprone, lower...

Fig. 7.23. The “rollover sequence”...

Fig. 7.24. Accupuncture points.

Fig. 7.25. Hydrotherapy in labor. (a) Shower...

Fig. 7.26. Positions for tired...

Fig. 7.27. Sterile water injection points.

CHAPTER 08

Fig. 8.1. Latent phase of the...

Chart 8.1. Spontaneous bearing...

Chart 8.2. Diffuse pushing without...

Fig. 8.2. Pushing positions that...

Fig. 8.3. (a) Right occiput posterior...

Fig. 8.4. Drive angle. (a) Supine. (b) Sitting...

Fig. 8.5. (a) Exaggerated lithotomy...

Fig. 8.6. Pushing positions to promote...

Fig. 8.7. (a) Semisitting to...

Fig. 8.8. (a) Squatting with...

Fig. 8.9. (a) Asymmetrical...

Fig. 8.10. (a) Pregnant person...

Fig. 8.11. Positions in which...

Fig. 8.15. Standing lunge.

Fig. 8.16. Kneeling lunge.

Fig. 8.17. Slow dancing.

Fig. 8.18. (a) Counterpressure. (b) Counterpressure...

Fig. 8.19 More strategies...

Fig. 8.20. (a) Knee press, laboring...

Fig. 8.21. (a) Objects for heat and...

Fig. 8.22. Intradermal sterile water...

Fig. 8.23. Transcutaneous nerve...

Fig. 8.24. Hydrotherapy for back...

Fig. 8.25. (a) Asynclitic fetus...

Fig. 8.26. (a) Posterior asynclitism...

Chart 8.3. Occiput posterior/asynclitism...

Fig. 8.27 Fetus emerging with...

Fig. 8.28. Supported crowning.

Fig. 8.29. (a) Laboring person...

Fig. 8.30. (a) Neonate brought...

Fig. 8.31a. Birth giver with...

Fig. 8.31b. Skin to skin.

Fig. 8.31c. Cutting the cord.

Fig. 8.31d. Breastfeeding...

Fig. 8.32. Sitting...

Fig. 8.33. Pushing on a birthing...

Fig. 8.34. (a) and (b) Pregnant...

Fig. 8.35. Pregnant person with...

Fig. 8.36. (a) Supported squat...

Fig. 8.37. (a) Squatting with...

Fig. 8.38. Sitting, leaning forward...

Fig. 8.39. Laboring person...

Fig. 8.40. (a) Standing lunge. (b) Kneeling...

Fig. 8.41. (a) Slow dancing. (b) Stair climbing...

Fig. 8.42. Hands and knees position...

Fig. 8.43. (a) Semisitting...

Fig. 8.44. McRobert’s Maneuver...

Fig. 8.45. Suprapubic pressure. Assistant...

Fig. 8.46. Shrug Maneuver. Reprinted...

Fig. 8.47. (a) Neonatal suction tube...

Fig. 8.48. Flip Flop Pneumonic.

Fig. 8.49. Somersault maneuver. The...

CHAPTER 09

Fig. 9.1. Guarding the uterus.

CHAPTER 10

Fig. 10.1. Roll-over sequence. (a) Throne...

Fig. 10.2. Pushing positions that...

Chart 10.1. Delayed pushing with...

Fig. 10.3. Monitor strip showing...

CHAPTER 11

Fig. 11.1. Side‐lying.

Fig. 11.2. Side‐lying...

Fig. 11.3. Side‐lying...

Fig. 11.4. Side‐lying...

Fig. 11.5. Semiprone, lower...

Fig. 11.6. Semiprone, lower...

Fig. 11.7. Semiprone, with...

Fig. 11.8. Side-lying on the...

Fig. 11.9. Side-lying on the...

Fig. 11.10. Laboring person...

Fig. 11.11. Roll-over sequence. (a) Throne...

Fig. 11.12. Semiprone lunge.

Fig. 11.13. Semiprone lunge with peanut ball.

Fig. 11.14. Side-lying release. (a)...

Fig. 11.15. Semisitting. (a) To rest. (b) To...

Fig. 11.16. Sitting upright. (a) With...

Fig. 11.17. Sitting, leaning...

Fig. 11.18. Standing leaning...

Fig. 11.19. Kneeling. (a) Leaning...

Fig. 11.20. Hands and knees.

Fig. 11.21. Open knee–chest...

Fig. 11.22. Closed knee–chest...

Fig. 11.23. Asymmetrical upright...

Fig. 11.24. Squatting. (a) Partner...

Fig. 11.25. Supported squat. (a) Supported...

Fig. 11.26. (a) Birthing rope. (b) Half...

Fig. 11.35. (a) Standing lunge. (b) Kneeling...

Fig. 11.27. Lap squat, with three people.

Fig. 11.28. (a) Supine with hips and knees...

Fig. 11.29. Sheet pull-to-push. (a) Pulling...

Fig. 11.30. (a) Exaggerated lithotomy...

Fig. 11.31. (a) Pelvic rocking, first...

Fig. 11.32. Pelvic rocking with...

Fig. 11.33. (a) Hip sifting, starting...

Fig. 11.34. Flexion and rocking on...

Fig. 11.36. (a) Walking. (b) Stair...

Fig. 11.37. Slow dancing.

Fig. 11.38. (a) Abdominal lifting. (b) Abdominal...

Fig. 11.39. Abdominal jiggling...

Fig. 11.40. (a) Positioning for...

Fig. 11.41. (a) Sitting in a rocking...

CHAPTER 12

Fig. 12.1. Heat.

Fig. 12.2. (a) Cold. (b) Rolling...

Fig. 12.3. (a) Shower on laboring...

Fig. 12.4. Water immersion. (a) Side-lying...

Fig. 12.5. (a) “Criss-cross” back...

Fig. 12.6. (a) Hand massage, thumbs...

Fig. 12.7. (a, b) “Pressure...

Fig. 12.8. “Squeezing the...

Fig. 12.9. Deep massage with...

Fig. 12.10. Acupressure points: hoku...

Fig. 12.11. (a) Doula supporting a laboring...

Fig. 12.12. (a) Counterpressure. (b) Counterpressure...

Fig. 12.13. (a) Double hip squeeze. (b) Double...

Fig. 12.14. (a) Knee press, seated. (b) Knee...

Fig. 12.15. (a) Bony landmarks for Cook’s...

Fig. 12.16. (a) Location of Cook’s perilabial...

Fig. 12.17. (a) Sources for cold: Cold gel...

Fig. 12.18. (a) Shower on laboring...

Fig. 12.19. (a) Walking. (b) Standing...

Fig. 12.20. (a) Sitting, swaying on a...

Fig. 12.21. (a) Transcutaneous electrical...

Fig. 12.22. Sterile water injection points.

Guide

Cover

Title Page

Copyright Page

Dedication

Table of Contents

List of Contributors

Foreword

Begin Reading

Index

End User License Agreement

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List of Contributors

Editors:

Lisa Hanson PhD, CNM, FACNM, FAANKlein ProfessorAssociate Director, Midwifery ProgramMarquette University, USACollege of NursingMilwaukee, WI

Emily Malloy PhD, CNMCertified Nurse MidwifeDirector of Midwifery ResearchMidwifery and Wellness CenterAurora Sinai Medical CenterParticipating FacultyMarquette University, USACollege of NursingMilwaukee, WI

Penny Simkin BA, PT, CCE, CD(DONA)Certified Birth Doula and Certified Childbirth Educator,USA

Contributing Authors:

Nicole Carlson PhD, CNM, FACNM, FAANAssociate ProfessorNell Hodgson Woodruff School of NursingEmory University Atlanta, Georgia, USA

Joyce K. Edmonds, PhD, MPH, RNSenior Research ScientistAriadne LabsHarvard T.H. Chan School of Public HealthBoston, MA, USA

Elise Erickson PhD, CNM, FACNMAssistant ProfessorThe University of Arizona AZ, USACollege of Nursing: Advanced Nursing Practice & ScienceCollege of Pharmacy: Pharmacy Practice & ScienceCollege of Medicine: Department of Obstetrics &Gynecology

Wendy Gordon, DM, MPH, CPM, LMChair & Associate ProfessorDepartment of MidwiferyBastyr UniversityWA, USA

Amy Marowitz, DNP, CNMAssociate ProfessorDepartment of Midwifery and Women’s HealthFrontier Nursing UniversityKentucky, USA

Sharon Muza, BS, CD/BDT(DONA), LCCE, FACCE, CLESeattle Area Certified Birth Doula and LamazeCertified Childbirth Educator

Kathryn Osborne PhD, CNM, FACNMAssociate ProfessorDepartment of Women, Children and Family NursingCollege of NursingRush UniversityChicago, USA

Amber Price DNP, CNM, RNPresidentSentara Williamsburg Regional Medical CenterWilliamsburg, VA, USA

Jesse Remer, BS, CD(DONA), BDT(DONA),LCCE, FACCEFounder, Mother Tree International

Karen Robinson, PhD, CNM, FACNMInterim Assistant Dean of Graduate ProgramsAssociate ProfessorMarquette University College of Nursing

Venus Standard MSN, CNM, LCCE, FACNMDirector, DEI Education and Community EngagementDirector and Co-Principal Investigator of LEADoulaprogramUniversity of North Carolina School of MedicineColumbia, USADepartment of Family MedicineWomen's Health - Maternal and Child Health

Ellen L. Tilden, PhD, RN, CNM, FACNM, FAANAssociate ProfessorOregon Health and Science University Portland, Oregon, USA

School of Nursing, Nurse-Midwifery DepartmentSchool of Medicine, OBGYN DepartmentCenter M Co-Founder and CSO

Gail Tully, BS, CPMSpinning Babies®

Robin Elise Weiss, Ph.D., MPH, CLC, LCCE, FACCE, AdvCD/BDT(DONA)DONA International

Foreword

Writing a Forward to the 5th edition of Simkin Penny’s Labor Progress Handbook brings to mind many of Penny’s workshops that I attended either as an attendee or rarely a co-teacher. Penny’s genius is her ability to present in a way that is accessible and pertinent to childbirth educators, doulas, family doctors, midwives, maternity nurses, and obstetricians. The Simkin’s Labor Progress Hanbook evokes memories of Penny’s workshops, where a mélange of maternity professionals of all kinds working, together on the floor and on birthing balls, or squeezing each other’s pelvises or squatting in the correct position, with heels down or incorrect, heels up—demonstrating how the former opens the pelvic floor while the latter does not. What a collaborative scene!

How did Penny do it, when the normally separate but obviously related disciplines rarely learn together? Penny’s understated and matter-of-fact, just-get-on-with-it approach engaged participants in an uplifting experience—an exercise based on her long-acquired knowledge as a physiotherapist applying her understanding of anatomy to birthing. No wonder Penny’s workshops were always full. The Simkin’s Labor Progress Handbook is deeply reflective of this experience, and the collaboration of the many birth disciplines is reflected in the authorship.

Penny was one of the founders of the doula movement, who, along with Marshall Klaus, Phyllis Klaus, John Kennel, and Annie Kennedy, embraced this new collaborator, and worked to bring doulas into the mainstream—fully appreciating how difficult that was going to be.1 That doulas were part of the workshops made a statement that doulas could add their knowledge, as demonstrated in the Simkin’s Labor Progress Handbook, to that of the other birth providers, even while the doula’s allegiance and responsibility was to the laboring person only–and not the hospital or other institution.2

Reading Simkin’s Labor Progress Handbook, one comes to the realization that it fits into the knowledge gap between a dry obstetrical textbook, cold evidence from a randomized controlled trial (with all its issues of generalizability)3 and the bedside or floor side of real laboring persons and their supporters. Reading Simkin’s Labor Progress Handbook is like being in one of Penny’s workshops, navigating between evidence coming from multiple conventional sources and the lived experience of the multidisciplinary participants–respectfully appreciating the practice lives of all. I am especially excited to see so many midwifery scientists and doula clinical experts carry on the legacy of Penny’s book and renaming it in her honor.

As in the introductory chapter, I too grappled with the narrow perspective of the three Ps, and in appreciation of Penny’s many contributions, I offer my version of the three Ps:

The 3 Ps Expanded**

1.

Power

– strength, length, duration of contractions

2.

Passage

– the pelvis; shape, size, angles

3.

Passenger

– the baby; size, position, and attitude.

These are the commonly recognized “P’s,” to which we add nine more to consider:

4.

Person

– the laboring person’s beliefs, preparation, knowledge, and “capacity” for doing the work of labor and birth

5.

Partner

– how the laboring person is supported and their knowledge, beliefs and preparation for the labor is integrated

6.

People

– the “entourage” – others who may be involved in the birth process and their beliefs, preparation, and knowledge of the process

7.

Pain

– the

laboring person’s

past experiences of pain and the experience of pain in psychological and cultural terms: beliefs, environment, on the laboring person’s capacity for coping with labor and birth.

8.

Pain

–

OURS

: how we professionals think of pain and manage it—seeking to abolish it or use it; how we professionals time the pain management tools at our disposal to minimize further interventions

9.

Professionals

–the manner in which all members of the healthcare team support, inform, and collaborate in care and information-sharing with the woman and her partner.

10.

Passion

– the

Laboring Person’s

. The experienced journey of pregnancy, labor, and birth is one that is special and unique to each participant. It is crucial for all parties involved in the care to be recognized and honored, and that this principle guide us in our practice.

11.

Passsion

–

OURS

. The passion toward maternity care that drives us

a) But for the woman and her supports, we need to recognize the importance of intimacy in this life-changing experience.

b) We need to control our anxiety and need for perfection so that the laboring person can fully experience the passion – even when the birth is complex and requires considerable help from us.

12.

Politics

– enough said

–

You know it’s true!

** MCK: Borrowed, stolen and modified from too many people to mention

Michael C Klein CM, MD, FCFP CCFP FAAP (neonatal-perinatal)Emeritus ProfessorFamily Practice & PediatricsUniversity of British ColumbiaSenior Scientist EmeritusBC Children’s Hospital Research Institute, VancouverRecipient The Order of [email protected] Dissident Doctor—catching babies and challenging the medical status quo.2018. Douglas and McIntyre. ISBN 978–1–77162–192–2

REFERENCES

1. Eftekhary S, Klein, MC, Xu, S. (2010) The life of a Canadian doula: Successes, confusion, and conflict.

Journal of Obstetrics and Gynaecology Canada

32(7), 642–649.

2. Amram N, Klein, MC, Mok, H, Simkin, P, Lindstrom, K, Grant, J. (2014) How birth doulas help clients adapt to changes in circumstances, clinical care, and client preferences during labor.

The Journal of Perinatal Education

23(2), 96–103.

3. Klein MC. (2023) Homage to Dr. Murray Enkin and the complexity of evidence-based medicine.

Birth

50(2), 255–257. doi: 10.1111/birt.12723.

Chapter 1 Introduction

Lisa Hanson, PhD, CNM, FACNM, FAAN and Emily Malloy, PhD, CNM

Causes and prevention of labor dystocia: a systematic approach

Notes on this book

Note from the authors on the use of gender-inclusive language

Conclusion

References

CAUSES AND PREVENTION OF LABOR DYSTOCIA: A SYSTEMATIC APPROACH

Labor dystocia, dysfunctional labor, failure to progress, arrest of labor, arrested descent—all these terms refer to slow or no progress in labor, which is one of the most vexing, complex, and unpredictable complications of labor. Labor dystocia is the most common medical indication for primary cesarean sections.1 Some have suggested that the use of the term “dystocia” be abandoned in favor of more precise definitions since one clear explanation is lacking.1 The modern course of labor is very different than in the past, and optimal strategies to reduce unnecessary interventions while providing interventions when needed and appropriate are still under investigation.2 Dystocia also contributes indirectly to the number of repeat cesareans, especially in countries where rates of vaginal births after previous cesareans (VBAC) are low. Thus, preventing primary cesareans for dystocia decreases the total number of cesareans. The prevention of dystocia also reduces the need for many other costly, time-intensive, and possibly risky interventions, and spares the laboring person from discouragement and disappointment that often accompany a prolonged or complicated birth.3

The possible causes of labor dystocia are numerous. Some are intrinsic:

The powers (uterine contractions).

The passage (size, shape, and joint mobility of the pelvis and the stretch and resilience of the vaginal canal).

The passenger (size, shape, and flexion of fetal head, fetal presentation, and position).

The pain (and the laboring person’s ability to cope with it).

The psyche (emotional state of the laboring person).

Others are extrinsic:

Environment (the feelings of physical and emotional safety generated by the setting and the people surrounding the laboring person).

Ethno‐cultural factors (the degree of sensitivity and respect for the person’s culture‐based needs and preferences).

Hospital or caregiver policies (how flexible, family‐ or person‐centered, how evidence‐based).

Psycho‐emotional care (the priority given to non‐medical aspects of the childbirth experience).

The focus of Simkin’s Labor Progress Handbook is on prevention, differential diagnosis, and early interventions to use to prevent labor dystocia. We emphasize relatively simple care measures and low technology approaches designed to help maintain normal labor progress, and to manage and correct minor deviations before they become serious enough to require technologic interventions. We believe this approach is consistent with worldwide efforts, including those of the World Health Organization, to reserve the use of medical interventions for situations in which they are needed: “The aim of the care [in normal birth] is to achieve a healthy mother [birth parent] and baby with the least possible level of intervention that is compatible with safety.”4

The suggestions in this book are based on the following premises:

The timing of dystocia is an important consideration when establishing cause and selecting interventions.

Sometimes several causal factors can occur simultaneously.

Clinicians and caregivers are often able to enhance or maintain labor progress with simple non‐surgical, non‐pharmacological physical, and psychological interventions. Such interventions have the following advantages:

Compared to most obstetric interventions for dystocia, they carry less risk of harm or undesirable side effects to laboring person or fetus;

The laboring persons is autonomous with the right to accept or refuse interventions. These suggestions treat the laboring person as the key to the solution, not part of the problem;

They build or strengthen the cooperation between the laboring person, their support people (loved ones, doula), and their clinicians;

they reduce the need for riskier, costlier, more complex interventions;

They may increase the person’s emotional satisfaction with their experience of birth.

The choice of solutions depends on the causal factors, if known, but trial and error is sometimes necessary when the cause is unclear. The greatest drawbacks are that the laboring person may not want to try some interventions; they may take time; and/or they may not correct the problem.

Time is usually an ally, not an enemy. With time, many problems in labor progress are resolved. In the absence of medical or psychological contraindications, patience, reassurance, and low‐ or no‐risk interventions may constitute the most appropriate course of management.

The clinician may use the following to determine the cause of the problem(s):

Objective data: vital signs; fetal heart rate patterns; fetal presentation, position, and size; cervical assessments; assessments of contraction strength, frequency, and duration; membrane status; and time;

Subjective data: person’s affect, description of pain, level of fatigue, ability to cope using self‐calming techniques:

Essential components:

– Attentive listening

– Informed consent and refusal

– Shared decision-making with the laboring person

Chart 1.1 illustrates the step-by-step approach followed in this book—from detection of little or no labor progress through graduating levels of interventions (from simple to complex) to correct the problem.

Chart 1.1. Care plan for the problem of “little or no labor progress.”

If the primary physiologic interventions are contraindicated or if they are unsuccessful, then secondary—relatively low‐technology—interventions are used, and only if those are unsuccessful are tertiary, high‐technology obstetrical interventions instituted under the guidance of the physician or midwife. Other similar flow charts appear throughout this book showing how to apply this approach to a variety of specific causes of dysfunctional labor.

Many of the interventions described here are derived from the medical, midwifery, nursing, and childbirth education literature. Some of the strategies described in this book lend themselves to randomized controlled trials, others do not. Others come from the psychology, sociology, and anthropology literature. Suggestions also come from the extensive wisdom and experience of nurses, midwives, physicians, and doulas and other labor support providers. Many are applications of physical therapy principles and practices. The fields of therapeutic massage and chiropractic provide methods to assess and correct soft tissue tension and imbalance that can impair labor progress. We have provided references for these, when available. Some items fall into the category of “shared wisdom,” where the original sources are unknown.

During the past half‐century, extensive scientific evaluation of numerous entrenched medical customs, policies, and practices, intended to improve birth outcomes, has determined that many are ineffective or even harmful. Routine practices, such as enemas, pubic shaving, routine continuous electronic fetal monitoring, maternal supine and lithotomy positions in the second stage of labor, routine episiotomy, immediate clamping of the umbilical cord, routine suctioning of the newborn’s airway after birth, and separation of the newborn from parent/s are examples of care practices that became widespread before they were scientifically evaluated. Scientific study now shows that these common practices were not only ineffective, they increased the risks for the birthing person and neonate.5

Other valid considerations, such as the laboring person’s needs, preferences, and values, also play a large role in the selection of approaches to their care. Our paradigm is one of respectful maternity care, although we recognize that throughout history and around the world, laboring people have been subject to racism, sexism, gender discrimination, disrespect, and other abusive and harmful behaviors. It is our expectation that laboring people are treated using a respectful maternity care and human rights model.

Racism and white supremacy are pervasive in obstetric care. Scholars have identified that many of the people identified as early founders of obstetrics and gynecology learned their skills through experimentation, coercion, and abuse of black, brown, and poor birthing people.6 Therefore, in this book, we will avoid using the names of those early experimenters in favor of descriptive terminology, for example, left side lying, or runner’s lunge for the position formerly called by a gynecologist’s name. Additionally, for one hundred years, nurses, midwives, and physicians were taught a system of pelvic classification with the aim of predicting difficult births that was overtly racist, and based only on pseudoscience.7 Therefore, in this book, we recognize that humans and pelvises are dynamic, and there is not one perfect pelvis. Rather, our goal is to help birthing people and birth workers take advantage of the mobility of the pelvis. The interventions and positions shown throughout this book are offered to provide many options in one place, rather than a “one size fits all” approach.

Maternity care practices, providers, and outcomes differ around the world. Many counties have recognized the importance of improving maternal and neonatal care, although progress has been slow.8,9 During the past decade, increasing evidence has pointed to the importance of midwives to improve outcomes. In 2014 the Lancet published a series on midwifery in four papers.10–13 The goal of the series was to correct misunderstandings about the midwifery profession. An important conclusion of the series was that better utilization of midwives could prevent a significant portion of perinatal morbidity, including stillbirth. Many countries are working toward a goal of strengthening their midwifery workforce and increasing access to midwifery care to decrease maternal morbidity and mortality.14 Midwifery care is associated with more spontaneous vaginal birth, less preterm birth, less epidural use, less episiotomy use, fewer instrumental births.15 Currently, we must find the balance between intervention and non-intervention. There is a time and place for both, but around the world more labor interventions are occurring without an improvement in outcomes for pregnant and birthing people and their newborns.

Depending on healthcare setting, midwifery training and availability, the World Health Organization makes a recommendation for Midwifery Led Continuity of Care models (MLCC).16 MLCC involves care by a midwife or team of midwives during the antenatal, intrapartum, and postpartum period.16 MLCC does not exclude other caregivers from providing care, but rather starts most pregnant people with the midwifery model, and those who need care by other professionals are referred based on their specific needs or conditions. While high-risk pregnant people benefit from the care of an obstetrician, low-risk pregnant people generally benefit from less invasive approaches to care provided by a midwife or family/general physician. Midwifery care is rooted in evidence-based care—a combination of research evidence, clinical experience, and the needs and wishes of the pregnant, laboring, or birthing person.17

May 5 is the International Day of the Midwife; in 2021 the theme of the day was “follow the data and invest in midwives.”14 Midwifery care varies widely by country. In the UK midwives and general practice providers deliver 80% of maternity care while in the United States midwives deliver approximately 10% of maternity care.18,19 In some countries, such as Germany and Japan, there are many more midwives than obstetricians.20 Many countries are working to increase their midwifery workforce, such as India, which has developed the Nurse Practitioner in Midwifery credential and Mexico which started an Initiative to Promote Professional Midwifery in 2015.21,22

The intention of this book is to be widely applicable in many different settings and to many different clinicians and support people, including nurses, midwives, physicians, doulas, and others. The differences in clinicians and their differing approaches to childbirth are reflected in the varying rates of interventions and cesarean births when labor is considered low risk. We hope that this book will offer tools for use in many different settings and situations.

NOTES ON THIS BOOK

This book is directed toward caregivers—midwives, nurses, doulas, and physicians—who want to support and protect the physiological process of labor, with the objective of avoiding complex, costly, and more risky interventions. It will also be helpful for students in midwifery, maternity nursing, and obstetrics; for childbirth educators (who can teach many of these techniques to expectant parents); and for doulas (trained labor support providers whose scope of practice includes use of many of the non‐clinical techniques). The chapters are arranged chronologically according to the phases and stages of labor.

NOTE FROM THE AUTHORS ON THE USE OF GENDER-INCLUSIVE LANGUAGE

We acknowledge that pregnant and birthing people may or may not identify with the gendered terms woman/women/she/her/hers. Therefore, in this edition we include the use of gender-inclusive language and use the terms pregnant, laboring, or birthing person. This is to avoid making assumptions about those who give birth. There remain references to women and/or mothers when citing scientific literature where participants described themselves as female or the researchers identified the person as a woman or mother.

CONCLUSION

The fifth edition of this book is named to honor Penny Simkin, the original author of this book. She is a world-famous doula, childbirth educator, and author of numerous articles and books. Simkin’s Labor Progress Handbook welcomes many new chapter authors and contributors who are expert midwifery clinicians, doulas, childbirth educators and/or scientists. This book focuses on prevention of labor dystocia, and a stepwise progression of interventions aimed at using the least invasive approaches that will result in safe delivery. To our knowledge, this is the first book that compiles labor progress strategies that can be used by a variety of clinicians and support people in a variety of locations. Most of the strategies described can be used for births occurring in hospitals, at home, and in free‐standing birth centers.

Knowledge of appropriate early interventions may spare pregnant people from long, discouraging, or exhausting labors, reduce the need for major interventions, and contribute to safer and more satisfying outcomes. The laboring person may not even recognize the intervention done for them, but they will appreciate and always remember your attentiveness, expertise, respect, and support as they brought their child into the world. This will contribute so much to their satisfaction and positive long‐term memories of their childbirths.23 We wish you much success and fulfilment in your important work.

REFERENCES

1. Neal JL, Ryan SL, Lowe NK, Schorn MN, Buxton M, Holley SL, Wilson‐Liverman AM. (2015) Labor dystocia: Uses of related nomenclature.

Journal of Midwifery & Women’s Health

60(5), 485–498.

2. Myers ER, Sanders GD, Coeytaux RR, McElligott KA, Moorman PG, Hicklin K, Grotegut C, Villers M, Goode A, Campbell H, Befus D, McBroom AJ, Davis JK, Lallinger K, Fortman R, Kosinski A. (2020)

Labor Dystocia

. Agency for Healthcare Research and Quality (US).

3. (2019 Feb) ACOG Committee Opinion No. 766: Approaches to Limit Intervention During Labor and Birth.

Obstetrics and Gynecology

133(2), e164–e173. doi:

10.1097/AOG.0000000000003074

. PMID: 30575638.N.

4. World Health Organization. (1996)

Care in Normal Birth: A Practical Guide

. Geneva: WHO.

Chapter 1

. Available from:

http://apps.who.int/iris/bitstream/10665/63167/1/WHO_FRH_MSM_96.24.pdf

5. Block J. (2007)

Pushed: The Painful Truth about Childbirth and Modern Maternity Care

. Cambridge, MA: Da Capo Lifelong.

6. Cooper Owens D. (2017)

Medical Bondage. Race, Gender, and the Origins of American Gynecology

. Athens, GA: University of Georgia Press. ISBN-10: 9780820351353.

7. VanSickle C, Liese KL, Rutherford JN. (2022) Textbook typologies: Challenging the myth of the perfect obstetric pelvis.

Anatomical Record (Hoboken, N.J.: 2007)

305(4), 952–967. doi:

10.1002/ar.24880

8. Kennedy HP, Cheyney, M, Dahlen, HG, Downe, S, Foureur, MJ, Homer, C, Jefford, E, McFadden, A, Michel-Schuldt, M, Sandall, J, Soltani, H, Speciale, AM, Stevens, J, Vedam, S, Renfrew, MJ. (2018) Asking different questions: A call to action for research to improve the quality of care for every woman, every child.

Birth (Berkeley, Calif.)

45(3), 222–231. doi:

10.1111/birt.12361

9. Kennedy HP, Balaam MC, Dahlen H, Declercq E, de Jonge A, Downe S, Ellwood D, Homer C, Sandall J, Vedam S, Wolfe I. (2020) The role of midwifery and other international insights for maternity care in the United States: An analysis of four countries.

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47(4), 332–345. doi:

10.1111/birt.12504

10. Homer CS, Friberg, IK, Dias, MA, ten Hoope-Bender, P, Sandall, J, Speciale, AM, Bartlett, LA (2014) The projected effect of scaling up midwifery.

Lancet (London, England)

384(9948), 1146–1157. doi:

10.1016/S0140-6736(14)60790-X

11.Renfrew MJ, McFadden, A, Bastos, MH, Campbell, J, Channon, AA, Cheung, NF, Silva, DR, Downe, S, Kennedy, HP, Malata, A, McCormick, F, Wick, L, Declercq, E. (2014) Midwifery and quality care: Findings from a new evidence-informed framework for maternal and newborn care.

Lancet (London, England)

384(9948), 1129–1145. doi:

10.1016/S0140-6736(14)60789-3

12. ten Hoope-Bender P, de Bernis, L, Campbell, J, Downe, S, Fauveau, V, Fogstad, H, Homer, CS, Kennedy, HP, Matthews, Z, McFadden, A, Renfrew, MJ, Van Lerberghe, W. (2014) Improvement of maternal and newborn health through midwifery.

Lancet (London, England)

384(9949), 1226–1235. doi:

10.1016/S0140-6736(14)60930-2

13. Van Lerberghe W, Matthews Z, Achadi E, Ancona C, Campbell J, Channon A, de Bernis L, De Brouwere V, Fauveau V, Fogstad H, Koblinsky M, Liljestrand J, Mechbal A, Murray SF, Rathavay T, Rehr H, Richard F, ten Hoope-Bender P, Turkmani S. (2014) Country experience with strengthening of health systems and deployment of midwives in countries with high maternal mortality.

Lancet (London, England)

384(9949), 1215–1225. doi:

10.1016/S0140-6736(14)60919-3

14. International Confederation of Midwives (ICM). (2021) Follow the data: Invest in midwives. Retrieved from

https://www.internationalmidwives.org/icm-events/international-day-of-the-midwife-2021.html

15. Sandall J, Soltani H, Gates S, Shennan A, Devane D. (2015) Midwife-led continuity models versus other models of care for childbearing women.

The Cochrane Database of Systematic Reviews

(9), CD004667. doi:

10.1002/14651858.CD004667.pub4

16. WHO. (2018)

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Birth

19(2), 64–81. doi: 10.1111/j.1523‐536X.1992.tb00382.x

Chapter 2 Respectful Care

Amber Price, DNP, CNM, RN

Health system conditions and constraints

LGBTQ birth care

RMC and pregnant people in larger bodies

Shared decision-making

Expectations

The impact of culture on the birth experience

Traumatic births

Trauma survivors and prevention of PTSD

Trauma-informed care as a universal precaution

Obstetric violence

Patient rights

Consent

Maternal mortality

References

Almost everywhere on the planet, people seek out others for assistance during the birth process. Rarely does birth happen in complete isolation, unless it is by choice or necessity. In years past, birth took place inside the home, visible and audible to all. When people lived in small communities, they relied on others in their communities to assist them. Few people had babies who had not been present at the births of siblings, grandmothers, neighbors, or friends. Demystifying birth having seen it left people prepared, with memories of the sounds and work of labor and birth, and of others successfully completing the journey.1 Attending birth fosters belief in the ability of the body to give birth, grows confidence, and normalizes the event. We are now in a time in history where people about to give birth have rarely witnessed it. Those who witnessed a birth on television likely saw a medicalized birth, in a hospital, with technology as a central feature.1 How a person witnesses birth shapes their belief of it. Every culture has its beliefs and rituals around birth, and while it is shrouded in mystery in some cases, it is a universal equalizer.

In most cultures, the societal norm is to present to a health care provider for confirmation of pregnancy as soon as possible.1