1. General introduction
Section 1: 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
Section 2: 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
Section 3: 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
Preface 2nd edition
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.