The Labor Progress Handbook : Early Interventions to Prevent and Treat Dystocia.

Intro -- Title Page -- Copyright Page -- Contents -- Foreword to the Fourth Edition -- Acknowledgments -- Chapter 1 Introduction -- Causes and prevention of labor dystocia: a systematic approach -- Differences in maternity care providers and practices in the united kingdom, the united states, and Canada -- Notes on this book -- Changes in this fourth edition -- A note from the authors on the use of gender-specific language -- Conclusion -- References -- Chapter 2 Normal Labor and Labor Dystocia: General Considerations -- What is normal labor? -- What is labor dystocia? -- Why does labor progress slow down or stop? -- Prostaglandins and hormonal influences on emotions and labor progress -- "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 woman: wellbeing or distress? -- Pain versus suffering -- Assessment of pain and distress in labor -- Assessment of women's ability to cope with the pain -- 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 -- An integrated philosophy on caring for trauma survivors -- Trauma histories: why they matter -- Childhood sexual abuse (CSA) and trauma in adulthood -- Traumatic births -- Trauma-informed care as a universal precaution -- Physical and physiologic measures to promote comfort and labor progress -- During labor: physical comfort measures -- During labor: physiologic measures -- Why focus on maternal position? -- Techniques to elicit stronger contractions -- Maintaining maternal mobility while monitoring contractions and fetal heart -- Auscultation -- When EFM is required: options to enhance maternal mobility -- Continuous EFM.

Intermittent EFM -- Wireless telemetry -- Conclusion -- References -- Chapter 3 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 -- Malposition -- Influencing fetal position prior to labor -- Identifying those fetuses likely to persist in an OP position throughout labor -- Influencing fetal position during labor -- Other assessments prior to labor -- Estimating fetal weight -- Assessing the cervix prior to labor -- The Bishop scoring system -- Assessments during labor -- Visual and verbal assessments -- Hydration and nourishment -- Psychology -- Quality of contractions -- External assessments -- Vital signs -- Quality of contractions -- Abdominal palpation (Leopold's maneuvers) -- Assessing the fetus -- 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 -- 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 4 Prolonged Prelabor and Latent First Stage -- The onset of labor: key elements in diagnosis -- Prelabor vs labor: the dilemma for expectant parents -- Symptoms that differentiate prelabor from early labor -- The six ways to progress in labor-prelabor to birth -- The Bishop Score.

Use of the "Six Ways to Progress" and the Bishop Score to help parents differentiate prelabor from labor -- Prolonged prelabor and latent phase of labor -- Can prenatal actions prevent some postdates pregnancies, prolonged prelabors, or early labors? -- Prenatal preparation of the cervix for dilation -- Attention to fetal factors that may prolong early labor -- Optimal fetal positioning: prenatal features -- Prenatal assessment and correction of suboptimal maternal musculoskeletal variations -- The woman who has hours of latent labor contractions without dilation -- Support measures for women 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 -- Other soft tissue (ligaments, muscles, fascia) factors -- Emotional factors -- Troubleshooting measures for painful prolonged prelabor or latent phase -- Measures to alleviate painful, non-progressing, non-dilating contractions in prelabor or the latent phase -- Synclitism and asynclitism -- Open knee-chest position -- Closed knee-chest position -- Side-lying release -- Conclusion -- References -- Chapter 5 Prolonged Active Phase of Labor -- What is active labor? Description, definition, diagnosis -- When is active labor prolonged? -- Observable characteristics of prolonged active labor -- Possible causes of prolonged active labor -- Fetal and fetopelvic factors -- Malposition, macrosomia, malpresentation, and cephalopelvic disproportion -- Persistent asynclitism -- Occiput posterior -- How fetal malpositions delay labor progress -- Problems in diagnosis of fetal position during labor -- Artificial rupture of the membranes with a malpositioned fetus -- Specific measures to address and correct problems associated with a "poor fit"-malposition, cephalopelvic disproportion, and macrosomia.

Maternal positions and movements for suspected malposition, cephalopelvic disproportion, or macrosomia -- Forward-leaning positions -- Side-lying positions -- Asymmetrical positions and movements -- Abdominal lifting -- An uncontrollable premature urge to push -- If contractions are inadequate -- Immobility -- Medication -- Dehydration and fear of dehydration -- Overhydration-excessive oral and/or intravenous fluids -- Exhaustion -- Uterine lactic acidosis as a cause of inadequate contractions -- When the cause of inadequate contractions is unknown -- Breast stimulation -- Walking and changes in position -- Acupressure or acupuncture -- Hydrotherapy (baths and showers: Fig. 5.20) -- If there is a persistent anterior cervical lip or a swollen cervix -- Positions to reduce an anterior cervical lip or a swollen cervix -- Other methods -- Manual reduction of a persistent cervical lip -- If emotional dystocia is suspected -- Assessing the woman's coping -- Western cultural attitudes on coping with labor -- Relaxation, Rhythm, and Ritual: The essence of "coping" during the first stage of labor77 -- Indicators of emotional dystocia during active labor -- Predisposing factors for emotional dystocia -- Helping the woman state her fears -- How to help a laboring woman in distress -- Special needs of childhood abuse survivors87 -- Incompatibility or poor relationship with staff -- If the source of the woman's anxiety cannot be identified -- Conclusion -- References -- Chapter 6 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 -- Avoid directing the woman to push during the latent phase of the second stage -- What if the latent phase of the second stage persists? -- The active phase of the second stage.

Support of spontaneous bearing down -- Physiologic effects of prolonged breath-holding and straining -- Effects on the woman -- Effects on the fetus -- Spontaneous expulsive efforts -- Diffuse pushing -- Second stage time limits -- Possible etiologies and solutions for second stage dystocia -- Maternal positions and other strategies for suspected occiput posterior or persistent occiput transverse fetuses -- Why not the supine position? -- Differentiating between pushing positions and birth positions -- 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 -- Manual interventions to reposition the occiput posterior fetus -- 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 -- Positions for suspected "cephalopelvic disproportion" (CPD) in second stage -- The use of supine positions -- Use of the exaggerated lithotomy position -- Shoulder dystocia -- If contractions are inadequate -- If emotional dystocia is suspected -- The essence of coping during the second stage of labor -- Signs of emotional distress in second stage -- Triggers of emotional distress unique to the second stage -- Conclusion -- References -- Chapter 7 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.

Management of delivery of an infant with a tight nuchal cord.

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