Simkin′s Labor Progress Handbook

 

Description:

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.

 

 

Table of Contents:

 

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

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An aparitie	5 ian 2024
Autor	L Hanson
Dimensiuni	186 x 234 x 26 mm
Editura	Wiley
Format	Paperback
ISBN	9781119754466
Limba	Engleza
Nr pag	384