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

Birth by caesarean can have an adverse psychological impact on some women and may affect their ability to adjust to motherhood. Most women want to avoid the surgical scars, both mentally and physically. With the cesarean section rate in the United States reaching a historic high and the limitations and risks associated with dystocia, it is no wonder why many women seek the help of birth professionals to navigate their way through labor. Dystocia or failure to progress in labor is the primary reason for cesarean deliveries. Penny Simkin’s and Ruth Ancheta’s The Labor Progress Handbook: Early Interventions to Prevent and Treat Dystocia focuses on non-invasive interventions to aid women experiencing difficult labor. The 2nd edition handbook, published by Wiley-Blackwell in 2005, describes and illustrates positions, movements and techniques that can be used to avoid medical interventions. The information is based on the principles of psychology, anatomy and physiology and is compiled from published research findings and clinical experience of the authors, doctors, midwives, nurses, doulas, anthropologists, childbirth educators and others.

The handbook is organized by stage of labor for easy reference containing flowcharts and illustrations that enable the caregiver or birth partner to quickly identify appropriate interventions to effectively treat dystocia. Although the book is beyond the doula’s scope of practice, it offers practical advice to caregivers who wish to help to prevent and treat dysfunctional labor. The Labor Progress Handbook gives a holistic approach to treating dystocia considering the woman’s emotional state, the impact of her birthing environment, and the influence that hospital policies may have on the outcome of her birth. Maternal position is the primary focus of this book. Frequent changes in position can resolve issues of occiput posterior position, asynclitism and deflexion. It also points out the differences between standard care in The United States, Canada and The United Kingdom.
 
The authors acknowledge the mind-body connection in labor and how doulas can have an impact on that aspect of childbirth. The reader is reminded to remain cognizant of her influence and to be sensitive to the needs of women experiencing prolonged labor while providing suggestions on how to avoid exhaustion. There are methods for identifying possible causes of prolonged labor and how to address them. I especially liked the way the authors approached the difficult subject of emotional fears linked to prior abuse and the extra care and kindness required when dealing with those types of situations.
 
The information in The Labor Progress Handbook successfully presents clinical wisdom from experienced birth workers and provides practical advice about what helps and what does not help women in labor. It places an emphasis on simple and sensible care measures that can be used to maintain normal progress and to manage and correct minor complications before they become severe. The writing is clear and effective without losing the reader in technical jargon. I like the way the book is organized according to birth stage with easy to follow illustrations and flowcharts for quick reference. It was an interesting read and one that I would recommend to anyone involved in the childbirth field.