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The Labor Progress Handbook: Early Interventions to Prevent and Treat Dystocia , 3rd ed Penny Simkin, Ruth Ancheta Wiley-Blackwell , Chichester, UK , 2011 $39.99 , 399 pp, pb

Every now and again a gem of a book for maternity caregivers comes along…a precious gem to be seized, treasured, and put immediately to use…The Labor Progress Handbook is such a book. Diony Young, Birth 2000;27(2):148–149

Eleven years ago I wrote these words in my review of the first edition of The Labor Progress Handbook by Penny Simkin and Ruth Ancheta. The value of this, the third edition, has multiplied with the years. It inherits and updates all the excellent information of the previous work—an essential resource on practical, noninvasive interventions to prevent or treat difficult labor and result in a safe, more satisfying outcome—with the addition of two new chapters. With each edition, the book has grown by almost 100 pages—evidence of its resounding success and the increase in knowledge and experience documented by the authors. Midwives Lisa Hanson, Suzy Myers, and Gail Tully also contribute importantly to this edition. As with the previous editions, explicit and simple line drawings by Shanna dela Cruz enhance the text throughout. The useful pocket-book size has been retained despite the additional pages and 32 new illustrations.

Simkin and Ancheta describe the book’s goals as follows (p 12):

This book is directed toward midwives, nurses, and doctors who want to support and enhance the physiologic process of labor with the objective of avoiding complex, costly, more risky interventions. It will also be helpful for students in obstetrics, midwifery, and maternity nursing; for childbirth educators who can teach many of these techniques to expectant parents; and for doulas who are qualified and skilled in the use of many of the techniques.

Indeed, the wealth of information here is indispensable to every clinician—step-by-step instructions and new techniques drawn from the authors’ experience and the latest scientific evidence. Each of the 10 chapters is evidence based and meticulously referenced. The book offers much more, however, as obstetrician Andrew Kotaska points out in his Foreword (p xv),

Where science can no longer inform us, we must rely on the experience, insight, and art of generations of skilled midwives and labor attendants, and this is where The Labor Progress Handbook is so helpful.

Simkin and Ancheta have arranged the text chronologically according to the phases and stages of labor, moving from general considerations of dysfunctional labor to assessment of labor progress, prolonged prelabor and latent first stage, prolonged active phase of labor, prolonged second stage, optimal newborn transition and management of third and fourth stages, low-technology clinical interventions to promote labor progress, and the Labor Progress Toolkit, comprising two final chapters—one on maternal positions and movements, and another on maternal comfort measures.

Hanson and Simkin co-author a new Chapter 7, “Optimal Newborn Transition and Third and Fourth Stage Labor Management,” which includes a critical and carefully documented examination of routine postpartum care practices within the context of physiologic and holistic management. This chapter covers topics that continue to be a source of debate among clinicians, such as expectant versus active management, immediate or delayed umbilical cord clamping, administration of uterotonic agents, oral and nasopharynx suctioning, and massage of the uterus. The management of the fourth stage of labor emphasizes the importance of promoting “family integration” and mother–baby togetherness through early and extensive skin-to-skin contact to foster newborn adaptation, breastfeeding, and maternal attachment behavior. The chapter also discusses Baby-Friendly breastfeeding practices and the timing of newborn assessments within the context of avoiding unnecessary separation of mother and baby.

“Low-Technology Clinical Interventions to Promote Labor Progress” is the new Chapter 8, authored by Lisa Hanson. It describes how clinicians can deal with problem labors—important techniques for managing shoulder dystocia in second stage, techniques for manually dilating a rigid cervix, digitally or manually rotating a malpositioned fetus in late labor, the “somersault maneuver” for delivering a baby with a tight nuchal cord, directed versus spontaneous pushing, perineal massage and protective management, and many other interventions. The chapter also includes a section on nonpharmacologic pain relief measures, such as acupuncture, sterile water injections, and nitrous oxide.

Each edition of The Labor Progress Handbook improves on the previous one, and this third edition is an even more indispensable resource for maternity care practitioners, especially within the context of today’s overuse of birth technology, cesarean sections, and nonevidence-based management practices. Congratulations, Penny Simkin and Ruth Ancheta! You’ve given caregivers a powerful gift to pass on to childbearing women … again!