| Acknowledgments | ix |
| Preface to the Fourth Edition | xi |
| Preface to the First Edition | xiii |
| Chapter 1 | The Midwife: A Profile | 1 |
| For Parents: Choosing a Midwife | 9 |
| Chapter 2 | Prenatal Care | 2 |
| The Initial Interview | 12 |
| Medical History | 14 |
| Physical Examination | 18 |
| High Risk Factors in Pregnancy | 19 |
| Nutrition and Exercise | 32 |
| Screening Out | 35 |
| Lab Work | 35 |
| Fetal Development | 41 |
| Routine Checkups | 42 |
| Common Complaints | 42 |
| Douche for Vaginal Infections | 46 |
| Herbs and Homeopathy in Pregnancy | 47 |
| Common Fears and Counseling Techniques | 50 |
| Partner Participation | 51 |
| Sibling Participation | 53 |
| The Last Six Weeks | 54 |
| Home Visits | 58 |
| Preparation for Water Birth | 59 |
| Last-Minute Clients | 60 |
| For Parents: Self-Care in Pregnancy | 63 |
| Chapter 3 | Problems in Pregnancy | 65 |
| Physical Complications | 65 |
| Anemia | 65 |
| Problems with Weight Gain | 67 |
| Miscarriage (Abortion) | 68 |
| Ectopic Pregnancy | 70 |
| Hydatidiform Mole | 70 |
| Bleeding Late In Pregnancy | 71 |
| Gestational Diabetes | 72 |
| Hypertension | 74 |
| Preeclampsia | 76 |
| Polyhydramnios/Hydramnios | 77 |
| Oligohydramnios | 78 |
| Multiple Pregnancy | 78 |
| Breech Presentation and Transverse Lie | 80 |
| Prematurity | 82 |
| Small for Gestational Age and Intrauterine Growth Restriction | 83 |
| Large for Gestational Age | 85 |
| Postdatism | 86 |
| Psychological Issues and Complications | 88 |
| Challenges Facing Single Mothers | 90 |
| Difficulties of Working Mothers | 91 |
| Challenges for Adoptive Mothers | 92 |
| Issues for Women Who Delay Childbearing | 93 |
| Problems of Estranged Couples | 94 |
| Challenges Facing Lesbian Mothers | 95 |
| Issues in Family Relationships | 96 |
| Sexual Problems | 97 |
| Abuse Issues | 99 |
| Psychological Screening Out | 101 |
| For Parents: Danger Signs in Pregnancy | 104 |
| Chapter 4 | Assisting at Births | 105 |
| Early Labor | 105 |
| Physical Assessments and Duties in Early Labor | 109 |
| Aseptic Technique and Universal Precautions | 110 |
| Active Labor | 111 |
| Physical Assessments and Duties during Active Labor | 113 |
| Transition | 116 |
| Cardinal Spiraling Movements of the Baby during Labor | 117 |
| Physical Assessments and Duties in Transition | 118 |
| Second Stage | 119 |
| Physical Assessments and Duties during Second Stage | 121 |
| Assisting Delivery 122 | |
| Herbs and Homeopathy during Labor | 127 |
| Third Stage | 129 |
| Assisting Placental Delivery | 130 |
| Checking for Tears | 130 |
| Newborn Exam | 133 |
| Postpartum Watch | 136 |
| For Parents: Golden Tips for Assisting in Labor | 138 |
| Chapter 5 | Complications in Labor | 139 |
| Prolonged Labor and Maternal Exhaustion | 140 |
| Cephalopelvic Disproportion | 145 |
| Posterior Arrest | 150 |
| Fetal Distress | 152 |
| Cord Problems | 153 |
| Maternal Hypertension | 154 |
| Prolonged Rupture of the Membranes | 155 |
| Unusual Presentations | 156 |
| Shoulder Dystocia | 159 |
| Surprise Breech | 161 |
| Amniotic Fluid Embolism | 162 |
| Hemorrhage | 163 |
| Retained Placenta | 169 |
| Giving an Injection | 170 |
| For Parents: In Case of Transport | 171 |
| Assessment and Repair of Lacerations and Episiotomy | 172 |
| Infant Resuscitation | 172 |
| Suturing Technique | 173 |
| Principles of Infant Resuscitation | |
| Fetal Anomalies | 180 |
| Stillbirth and Neonatal Death | 181 |
| Liam Andrew | 182 |
| Chapter 6 | Postpartum Care | 189 |
| Day-One Visit | 191 |
| Day-Three Visit | 194 |
| Day-Seven Visit | 196 |
| Three-Six Weeks Checkup | 197 |
| The Baby: Complications and Concerns | 198 |
| Hypoglycemia | 198 |
| Herbs and Homeopathy Postpartum | 199 |
| Meconium Aspiration | 201 |
| Transient Tachypnea | 201 |
| Neonatal Infection | 202 |
| Jaundice | 203 |
| Circumcision | 204 |
| For Parents: What to Do If the Baby Cries | 205 |
| Nervous Irritability/Colic | 205 |
| Minor Problems | 206 |
| The Mother: Complications and Concerns | 206 |
| Minor Problems | 206 |
| Hematoma | 207 |
| Uterine and Pelvic Infections | 207 |
| Thrombophlebitis and Pulmonary Embolism | 208 |
| Difficulties with Breastfeeding | 208 |
| Ten Steps to Successful Breastfeeding | 210 |
| Postpartum Depression | 210 |
| Sexual Adjustment | 214 |
| Contraception | 216 |
| Chapter 7 | Becoming a Midwife | 217 |
| Textbooks and Other References | 218 |
| Doula Work, or Birth Assisting | 220 |
| Birth Assisting at Home | 221 |
| Birth Assisting in Hospital | 223 |
| Midwifery Study Groups | 224 |
| Apprenticeship | 224 |
| Core Areas of Study | 225 |
| Other Direct-Entry Options | 227 |
| Nurse-Midwifery Programs | 227 |
| Chapter 8 | The Midwife's Practice | 229 |
| Location: Urban or Rural Practice? | 230 |
| Equipment | 232 |
| Setup and Administration | 233 |
| General Presentability and Personal Hygiene | 235 |
| Fees | 235 |
| Public Relations and Education | 236 |
| Medical Backup and Consultation | 238 |
| Medical Records, Charting, Informed Choice, and Client Confidentiality | 240 |
| Partnership | 243 |
| Training the Student or Apprentice | 244 |
| Peer Review | 247 |
| Chapter 9 | The Long Run | 249 |
| For Parents: Support Your Local Midwife! | 253 |
| Appendices | 255 |
| Appendix A | The MANA Statement of Values and Ethics, MANA Core-Competencies for Midwifery Practice, MANA Standards and Qualifications for the Art and Practice of Midwifery | 255 |
| Appendix B | Resources | 265 |
| Appendix C | Medical/Health History | 268 |
| Appendix D | Prenatal Care Record, Prenatal Care Progress Notes | 274 |
| Appendix E | Labor Record, Labor Progress Notes | 276 |
| Appendix F | Transport Record from Home Delivery | 278 |
| Appendix G | Birth Records | 279 |
| Appendix H | Newborn Examination | 280 |
| Appendix I | Clinical Estimation of Gestational Age | 281 |
| Appendix J | Postpartum Care, Postpartum Care Progress Notes | 282 |
| Appendix K | Postpartum Instructions | 284 |
| Appendix L | The Midwife's Kit, Parent's Supply List | 285 |
| Appendix M | Midwifery Programs and Institutions | 287 |
| Appendix N | HIPAA Guidelines | 294 |
| About the Author | 296 |
| Index | 297 |
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