Table of Contents
Preface to the Fourth Edition xi
Acknowledgments xvi
How to Use This Book xix
Part 1 Before the Birth 1
1 The Last Weeks of Pregnancy 3
What Kind of Birth Partner Will You Be? 4
Getting Ready for Labor 6
Preparing for Life with the Baby 30
On to the Next Step … 36
Part 2 Labor and Birth 37
2 Getting into Labor 39
Prelabor and the Labor Process 40
How Long Will Labor Last? 43
Signs of Labor 44
If Her Bag of Waters Breaks Before Labor Begins 47
"False" Labor, or Prelabor 49
Labor Progresses in Six Ways 50
Timing Contractions 53
3 Moving Through the Stages of Labor 57
Compare Labor to Running a Marathon 58
Prelabor 61
The First, or Dilation Stage 65
The Birthing Stage 89
The Placental Stage 102
Normal Labor-in a Nutshell 106
4 Comfort Measures for Labor 111
Pain versus Suffering 112
The Three Rs: Relaxation, Rhythm, and Ritual 114
Self-Help Comfort Measures 121
Comfort Aids and Devices 142
Comforting Techniques for You to Try 151
Taking Care of Yourself 161
Checklist of Comfort Measures for Labor 162
5 Strategies for Challenging Variations in Normal Labor 165
The Take-Charge Routine 166
On-the-Spot Coaching (When You Have Had No Childbirth Classes) 170
The Very Rapid Labor 171
The Emergency Delivery 173
When Labor Must Start (Labor-Stimulating Measures) 175
The Slow-to-Start Labor 180
Slow Progress in Active Labor and the Birthing Stage, with or without Back Pain 184
When the Mother Must Labor in Bed 188
A Breech Baby 190
A Previous Disappointing or Traumatic Birth Experience 194
Incompatibility with the Nurse or Caregiver 197
Part 3 The Medical Side of Childbirth 201
Key Questions for Informed Decision Making 202
6 Tests, Technologies, Interventions, and Procedures 205
Late-Pregnancy Tests 205
Essential Observations During Labor 209
Conditions Influencing the Amount of Intervention 211
Common Obstetric Interventions 212
7 Complications in Late Pregnancy, Labor, or Afterward 237
Complications for the Mother 238
The Breech Presentation 251
Complications with Labor Progress 251
Complications with the Fetus 256
Complications with the Newborn 261
After It Is All Over 267
8 Medications for Pain During Labor 269
Management of Normal Labor without Pain Medications 270
What You Both Need to Know About Pain Medications 272
The Mother's Decisions Regarding Pain Medications During Labor 290
Pain Medications Preference Scale 294
9 Cesarean Birth, and Vaginal Birth After Cesarean 305
Know the Nonmedical Reasons for Cesarean Birth and Factors to Consider 307
Know the Medical Reasons for Cesarean Birth 308
Know What to Expect During Cesarean Birth 310
Your Role During and After a Cesarean Birth 317
Vaginal Birth After Cesarean (VBAC) 320
Part 4 After the Birth 325
10 The First Few Days Postpartum 327
The First Few Hours 327
The First Few Days for the Baby 337
The First Few Days for the Mother 343
Homecoming 347
After a Home Birth 349
Getting Help and Advice 350
The Mother's Postpartum Emotions 351
What About Your Feelings? 354
Practical Matters at Home 354
11 Getting Started with Breastfeeding 361
Advantages of Breastfeeding 361
Getting Off to a Good Start 364
Early Concerns 365
When to Give the Baby a Bottle 372
Once Breastfeeding Is Established 374
Parting Words 375
Recommended Resources 377
Index 383
