Proactive Support of Labor enhances professional labor and delivery skills by providing the expertise for preventing prolonged labor which is the root-cause of women's dissatisfaction with the experience of childbirth. Step-by-step, evidence-based guidance on good practice during labor is given, including fetal and maternal monitoring, pain relief, and the prevention and timely correction of everyday labor disorders. It leaves no aspect of childbirth practice untouched. Included are guidance on adequate pre-labor education, psychological support, and well-defined birth-planning - including strict diagnoses and timely corrective measures in abnormal labor, and constant audit of all procedures. The birth-plan promotes team spirit between obstetricians, midwives and nurses, good communication, and sound organization. Proactive Support of Labor strikes a new balance between natural birth and intervention and invariably enhances women's satisfaction with the childbirth experience. The book will be essential reading for obstetricians, midwives, labor room nurses, and maternal-fetal medicine specialists and trainees. Paul Reuwer is an Obstetrician/Perinatologist at St. Elisabeth Hospital/Brabant Medical School, Tilburg, The Netherlands. Hein Bruinse is Professor of Clinical Obstetrics, Department of Obstetrics, University Medical Center Utrecht, The Netherlands. Arie Franx is Maternal Fetal Medicine Specialist, Department of Obstretrics and Gynecology, St. Elisabeth hospital/Brabant Medical School, Tilburg, The Netherlands. CONTENTS Foreword; 1. General introduction; Part I. A Wake-Up Call: 2. Medical excess in normal childbirth; 3. Iatrogenic causes of failed labors; 4. Harmful birth care practices; 5. Destructive territorial disputes; 6. Self-sustaining mechanisms; Part II. Back to Basics: 7. Lessons from nature; 8. Elementary biophysics of birth; 9. First stage labor revisited; 10. Second stage labor redefined; 11. Definitions and verbal precision; Part III. Proactive Support of Labor: 12. Introductory synopsis; 13. Nulliparous versus parous labor; 14. Diagnosis of labor; 15. Prevention of long labor; 16. Personal continuity and continuous support; 17. Amniotomy and oxytocin; 18. Labor pain in broader perspective; 19. Prelabor preparation; 20. Medical pain relief revisited; 21. Dynamic dystocia unraveled; 22. Mechanical birth obstruction; 23. Curtailed use of induction; 24. Intrapartum care of fetus; 25. Prevention of litigation; 26. Organizational reforms; 27. Continual audit and feedback; 28. Quality assessment; 29. Hospital statistics; 30. Sum of the parts; References; Index.