Natural Labor and Birth: An Evidence-Based Guide to the Natural Birth Plan

by Michelle Aristizabal

Overview

The first evidence-based book covering natural childbirth practices written by an obstetrician

Natural birth plans have emerged as a battle cry of resistance among women who are dissatisfied with today’s medically-aggressive model of maternity care and high cesarean section rates. However, natural birth does not need to be a source of controversy or conflict between women and their nurses and doctors.

Natural Labor and Birth: An Evidenced-Based Guide to the Natural Birth Plan seeks to broaden the medical community’s understanding of the motivations and needs of naturally laboring mothers, while also exploring why natural birth is often so difficult to achieve within our current system and what can be done to change that. It is a complete resource on the topic of natural childbirth, teaching healthcare providers and other birth workers the skills necessary to assist a woman through an unmedicated birth and reviewing the compilation of medical evidence in support of those methods. It demonstrates how natural birth can exist within the framework of traditional antepartum care and hospital deliveries, and offers alternative solutions to common challenges that often disrupt the physiologic birth process.

Natural Labor and Birth: An Evidenced-Based Guide to the Natural Birth Plan is also an unbiased resource for pregnant women seeking a more thorough and scientific understanding of unmedicated birth. This guide will help women and their partners make their own birth plans from a truly informed place. It will help women understand the barriers they may face when seeking a natural birth and give them the ability to better communicate their needs and preferences.

By creating room for natural birth within our maternity system, this book will help readers build a community of care where all women feel respected, acknowledged, and empowered during their birth experience.

Product Details

ISBN-13:	9781259862885
Publisher:	McGraw Hill LLC
Publication date:	09/14/2018
Sold by:	Barnes & Noble
Format:	eBook
File size:	8 MB

About the Author

Michelle Aristizabel, MD, FACOG (Montclair, NJ) is President, Owner, and Principle Physician in ObGyn at Wombkeepers Obstetrics and Gynecology and Maternity Wellness Center, Montclair, New Jersey; Attending Physician, St. Barnabas Medical Center and Hackensack University Medical Center.

Table of Contents

Preface ix

Section 1 The Battle for Natural Birth in the American Maternity System 1

1 Understanding the Motives for the Natural Birth Movement and Why the Medical Community Needs to Embrace It 3

2 Current Barriers to Natural Birth 23

3 Are Midwives the Solution? 49

Section 2 The Evidence in Support of a Natural Birth Plan 65

4 The Environment for Birth 71

5 Labor Management 85

6 Pain Management 127

7 Delivery 155

8 Post-Delivery Maternal and Infant Care 179

Section 3 Alternative Tools for Common Challenges 197

9 Labor Dystocia 199

10 Fetal Monitoring Challenges 215

11 Ineffective Pain Management 223

12 Integrating Medical Intervention into a Natural Birth Plan 233

13 Special Cases: Indicated Induction, VBAC, and High-Risk Patients Wanting a Natural Birth 251

Section 4 The Bookends of Holistic Maternity Care: The Antepartum and Postpartum Periods 269

14 Holistic Antepartum Care: The Foundation of a Natural Birth 271

15 Holistic Postpartum Care: Recognizing the Fourth Trimester 289

Index 319

Editorial Reviews

Reviewer: Cynthia Elizabeth Tetreault, BS (Indiana University School of Medicine)
Description: This book explains the current state of natural birth in U.S. and attempts to uncover why there is controversy surrounding this practice. It also provides evidence that supports natural birth practices and offers alternative tools for labor management and antepartum care.
Purpose: The purpose is to support the practice of natural labor as a reasonable alternative to aggressive medical management, which has become the standard in the U.S. It serves to increase awareness among expectant mothers of their birth options as well as provide a source of knowledge for obstetricians on methods of practicing natural labor and delivery. In addition, it broadens the medical community's understanding of the need and desire for natural childbirth practices. It is rare to find a book written from the perspective of a U.S.-trained OB/GYN who is practicing natural birth techniques and interested in motivating others to do the same. There is a huge lack of recognition and understanding of natural labor and delivery in the medical community and the author does an excellent job conveying this. The book does an excellent job explaining the practice of obstetrics so that a lay person can understand, but also gives enough detail that, as a medical student entering the field of obstetrics/gynecology, I am intrigued and have learned from her book. She provides clear and concise graphs to summarize main concepts of obstetrical care and images demonstrating alternative management methods.
Audience: According to the author, the book is written for fellow OB/GYN colleagues as well as soon to be mothers. However, it is also appropriate for medical students, residents, nurses, and the medical community at large because it calls into question the practice we are taught as we enter the field of OB/GYN. This book offers worthy sources and a thorough discussion of many aspects of obstetrics including prenatal care, the birth environment, management of active labor, pain control, delivery challenges, and postpartum care. The author leaves no stone unturned and meets the needs of her fellow OB/GYNs and any pregnant women who want a reliable source of information on natural birth. The author is a practicing board-certified OB/GYN who completed both medical school and residency in the U.S. and has been practicing natural labor and delivery with her own patients. She has a wide array of knowledge on this topic and has dedicated her career to furthering the practice of natural birth.
Features: The book discusses the shortcomings of the modern medical management of labor and delivery and the available scientific evidence that does not support many of the common practices. This includes the risks and benefits of the practice of induction at 41 weeks, C-sections, epidurals, positioning during labor, hydrotherapy, and much more. The author explains the different certifications for midwives and their role in today's medical system, as well as the ideal way to use midwives. She offers a glimpse into the life of a resident physician and helps explain why our obstetrical practices are so heavily geared towards medicine and surgery. She offers many alternatives to the standard medical management of pregnant patients and urges the medical community to take action and change. The author ensures that readers feel emotionally connected by sharing her own story, covering her medical education, residency, and current private practice. She engages readers with stories from patients and their experiences with birth in the U.S. and she compares these practices to those of other countries. This supports the notion that a push towards natural birth exists and that change is imminent. In addition to the subjective nature of these stories, the book includes many facts, statistics, and a critique of the scientific papers used in the writing of this book. The writing is clear with common obstetrical terms explained so the lay person can follow along. The book includes numerous charts that summarize common practices, medications, risks and benefits, etc. Many statistics are listed with each topic that help readers evaluate the results of a source and provide data that a physician can use in a discussion with a patient. Included are many anonymous personal stories of new mothers, which offer additional perspectives on natural birth. All sections of the book are clearly labeled and color coded to help readers quickly find a particular topic. An extensive list of references is included at the end of each chapter, which is of particular value to medical students, residents, and physicians who want to review the literature first hand. In addition, there are pictures of patients illustrating the various methods and techniques of natural labor, pain relief, and positions to help with common obstetrical challenges. An index helps to quickly locate a topic for review. There is some mention of the practice of obstetrics in other countries, but a greater discussion of how these practices differ and a comparison of maternal and infant mortality would add more support to the practice of natural birth and the argument that change in the U.S. is necessary.
Assessment: There are several other books on natural birth techniques, such as Active Birth: The New Approach to Giving Birth Naturally, Balaskas (Harvard Common Press, 1992), which guide the mother through techniques she can use during her delivery. However, this book is unique in that it is directed more towards obstetricians. The author describes the technique needed to deliver a baby in the hands and knees position and in the birth stool as well as how to manage shoulder dystocia in these positions. The author's goal is not only to inform, but to urge obstetricians to change their way of practicing and be open to using different techniques to manage labor. She helps physicians gain empathy with the laboring mother by including direct quotes from new moms. She also helps new moms understand why OB/GYNs are so driven towards medical management by providing a glimpse into the life of a medical resident and telling her own story of her struggle to use natural birthing techniques and be accepted by her colleagues. The author ensures that readers feel emotionally connected and empowers them to see the significance of the medicalization of obstetrical care and its deleterious effects. As a medical student entering the field of obstetrics, I am reminded that one must always question why we practice the way we do rather than just follow instructions and to remember that just because it is the norm does not make it best practice. One should always be open to learning new techniques, especially if they are beneficial to the patient.

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