Lisa Hanson PhD, CNM, FACNM, FAAN is Klein Professor and Associate Director of the Marquette University College of Nursing, Midwifery Program, Milwaukee, WI, USA. She practiced as a midwife for 30 years in Milwaukee, WI, USA. Lisa is an active midwifery researcher who has authored numerous scientific articles.
 
Emily Malloy PhD, CNM is a nurse-midwife in full scope midwifery practice and a midwife researcher who conducts clinical research in Milwaukee, WI, USA. She is a participating faculty at Marquette University College of Nursing, Midwifery program.
 
Penny Simkin BA, PT, CCE, CD(DONA) is a physical therapist who has specialized in childbirth education and labor support since 1968. She estimates she has prepared over 15,000 pregnant people, couples, and siblings for childbirth, and assisted hundreds as a doula. She is author of several books for both parents and professionals.

List of Contributors xvi
 
Foreword xviii
 
Chapter 1: Introduction 1
Lisa Hanson, PhD, CNM, FACNM, FAAN and Emily Malloy, PhD, CNM
 
Causes and prevention of labor dystocia: a systematic approach 1
 
Notes on this book 4
 
Note from the authors on the use of gender-inclusive language 5
 
Conclusion 5
 
References 5
 
Chapter 2: Respectful Care 7
Amber Price DNP, CNM, MSN, RN 7
 
Health system conditions and constraints 8
 
LGBTQ birth care 9
 
RMC and pregnant people in larger bodies 9
 
Shared decision-making 10
 
Expectations 11
 
The impact of culture on the birth experience 12
 
Traumatic births 12
 
Trauma survivors and prevention of PTSD 13
 
Trauma-informed care as a universal precaution 15
 
Obstetric violence 16
 
Patient rights 17
 
Consent 17
 
Maternal mortality 18
 
References 19
 
Chapter 3: Normal Labor and Labor Dystocia: General Considerations 22
Lisa Hanson, PhD, CNM, FACNM, FAAN, Venus Standard, MSN, CNM, LCCE, FACNM, andPenny Simkin, BA, PT, CCE, CD(DONA)
 
What is normal labor? 22
 
What is labor dystocia? 26
 
What is normal labor progress and what practices promote it? 26
 
Why does labor progress slow or stop? 28
 
Prostaglandins and hormonal influences on emotions and labor progress 29
 
Disruptions to the hormonal physiology of labor 30
 
Hormonal responses and gender 30
 
"Fight-or-flight" and "tend-and-befriend" responses to distress and fear during labor 31
 
Optimizing the environment for birth 32
 
The psycho-emotional state of the pregnant person: wellbeing or distress? 33
 
Pain versus suffering 33
 
Assessment of pain and coping 34
 
Emotional dystocia 34
 
Psycho-emotional measures to reduce suffering, fear, and anxiety 34
 
Before labor, what the caregiver can do 34
 
During labor: tips for caregivers and doulas, especially if meeting the laboring client for the first time in labor 37
 
Conclusion 38
 
References 38
 
Chapter 4: Assessing Progress in Labor 41
Wendy Gordon, DM, MPH, CPM, LM, with contributions by Gail Tully, BS, CPM, andLisa Hanson, PhD, CNM, FACNM, FAAN
 
Before labor begins 42
 
Fetal presentation and position 42
 
Abdominal contour 42
 
Location of the point of maximum intensity (PMI) of the fetal heart tones via auscultation 42
 
Leopold's maneuvers for identifying fetal presentation and position 46
 
Abdominal palpation using Leopold's maneuvers 46
 
Estimating engagement: The rule of fifths 49
 
Malposition 53
 
Other assessments prior to labor 53
 
Estimating fetal weight 53
 
Assessing the cervix prior to labor 54
 
Assessing prelabor 55
 
Six ways to progress 55
 
Assessments during labor 55
 
Visual and verbal assessments 55
 
Hydration and nourishment 55
 
Psychology 56
 
Quality of contractions 56
 
Vital signs 57
 
Purple line 58
 
Assessing the fetus 58
 
Fetal movements 58
 
Gestational age 58
 
Meconium 59
 
Fetal heart rate (FHR) 59
 
Internal assessments 67
 
Vaginal examinations: indications and timing 68
 
Performing a vaginal examination during labor 68
 
Assessing the cervix 69
 
Assessing the presenting part 70
 
Identifying those fetuses likely to persist in an OP position throughout labor 75
 
The vagina and bony pelvis 76
 
Putt

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