A Guide to Effective Care in Pregnancy and

The third edition of A guide to effective care in pregnancy and childbirth will be invaluable to anyone involved in the care of pregnant women, and to expectant parents. This updated guide summarizes the most authoritative evidence available on the effects of care practices carried out duringpregnancy, childbirth, and immediately after birth, in a clear and readily understandable format. In addition to the details provided in the text, the book concludes with six valuable tables that list the practices which are beneficial, those of unknown effectiveness, and those likely to beineffective or harmful. Based on the most systematic review to date, this comprehensive guide presents the main findings and conclusions in an easily readable, inexpensive, and conveniently-sized form. This third edition has been completely updated to include the new research evidence availablesince publication of the previous edition. Previous editions have received critical acclaim for conclusions based on sound evidence and have become a unique reference source for evaluating care policies and practices.

Murray W. Enkin MD, FRCS(C), LLD Professor Emeritus, Departments of Obstetrics and Gynecology, Clinical Epidemiology and Biostatistics, McMaster University Marc J. N. C. Keirse MD, DPHIL, DPH, FRANZCOG, FRCOG Professor and Head, Department of Obstetrics, Gynaecology and Reproductive Medicine, The Flinders University of South Australia. James P. Neilson BSC, MD, FRCOG Co-ordinating Editor, Cochrane Pregnancy and Childbirth Group. Professor of Obstetrics and Gynaecology, University of Liverpool Caroline A. Crowther MD, DCH, DDU, FRCOG, FRANZCOG, CMFM Associate Professor, Department of Obstetrics and Gynaecology, University of Adelaide Lelia Duley MD, MSC(Epid), MRCOG Obstetric Epidemiologist, Institute of Health Sciences, Oxford Ellen D. Hodnett RN, PHD Professor and Heather M. Reisman Chair in Perinatal Nursing Research, University of Toronto G. Justus Hofmeyr MBBCH, MRCOG Professor of Obstetrics and Gynaecology, Coronation Hospital and University of the Witwatersrand

Basic care
What do we mean by 'effective care'?	p. 3
Evaluating care in pregnancy and childbirth	p. 5
Support for pregnant women	p. 16
Antenatal education	p. 24
Lifestyle in pregnancy	p. 29
Dietary modification in pregnancy	p. 38
Screening
Risk scoring	p. 49
Imaging ultrasound in pregnancy	p. 53
Screening for congenital anomalies	p. 60
Screening for pre-eclampsia	p. 67
Gestational diabetes	p. 75
Assessment of fetal growth, size, and well-being	p. 79
Pregnancy problems
Unpleasant symptoms in pregnancy	p. 95
Miscarriage	p. 108
Hypertension in pregnancy	p. 119
Fetal compromise	p. 133
Multiple pregnancy	p. 141
Rhesus isoimmunization	p. 148
Infection in pregnancy	p. 154
Diabetes in pregnancy	p. 169
Bleeding in the latter half of pregnancy	p. 178
Suspected fetopelvic disproportion and abnormal lie	p. 185
Prelabor rupture of the membranes	p. 196
Preterm labor	p. 211
Promoting pulmonary maturity	p. 226
Post-term pregnancy	p. 234
Fetal death	p. 240
Childbirth
Social and professional support in childbirth	p. 247
Hospital practices	p. 255
Care of the fetus during labor	p. 267
Monitoring the progress of labor	p. 281
The second stage of labor	p. 289
The third stage of labor	p. 300
Problems during childbirth
Control of pain in labor	p. 313
Prolonged labor	p. 332
Repair of perineal trauma	p. 341
Preterm birth	p. 347
Labor and birth after previous cesarean section	p. 359
Techniques of induction and operative delivery
Preparing for induction of labor	p. 375
Methods of inducing labor	p. 383
Instrumental vaginal delivery	p. 397
Cesarean section	p. 404
Prophylactic antibiotics with cesarean section	p. 409
Care after childbirth
Immediate care of the newborn infant	p. 417
Mother and baby	p. 429
Breastfeeding	p. 439
Perineal pain and discomfort	p. 457
Breast symptoms in women who are not breastfeeding	p. 467
Loss and grief in the perinatal period	p. 471
Synopsis
Effective care in pregnancy and childbirth: a synopsis	p. 485
Beneficial forms of care	p. 487
Forms of care likely to be beneficial	p. 489
Forms of care with a trade-off between beneficial and adverse effects	p. 494
Forms of care of unknown effectiveness	p. 496
Forms of care unlikely to be beneficial	p. 500
Forms of care likely to be ineffective or harmful	p. 506
Index	p. 509
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A Guide to Effective Care in Pregnancy and Childbirth

Summary

Author Biography

Table of Contents

Supplemental Materials