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Evidence-based Care for Normal Labour and Birth: A guide for midwives

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Denis Walsh, midwife, midwifery consultant, and lecturer in the United Kingdom, believes profoundly in midwifery-led care and in the rhythmic course of physiological labor and birth. In his book, Evidence-Based Care for Normal Labour and Birth: A Guide for Midwives, addressing the relatively new evidence-based care paradigm, he seeks to expand the definition of "evidence" so that qualitative research gains credibility in a technological world enamored of quantification. He reminds readers of the huge collection of knowledge, ancient and modern, that qualifies as authentic evidence -- an extensive body of research supporting the natural physiology of labor and birth; midwives' intuitive and observational powers; and the unique stories, feelings, and reactions of birthing women throughout the ages. Much of this wisdom is in danger of being lost, submerged by the modern focus on technology and childbirth pathology that so many practitioners and childbearing women are struggling with each day.
Throughout, Walsh illustrates his points with studies and articles, suggesting the many areas that that call out for further exploration, and challenging readers to find ways to keep vital knowledge alive. Each chapter ends with "Practice Recommendations and Questions for Reflection.".
Among so many important issues, Walsh discusses "Evidence-based care: the new orthodoxy for maternity services," and acknowledges the proliferation of systematic reviews "embraced...with an almost evangelistic fervour." He critiques them, noting that many are politically laden efforts carried out against a background of increasing medicalization. Most research bypasses women's vital concerns, performed as it is in hospital settings subject to time pressures, institutional constraints and regulations, and mediated by power differences both within professional groups, and between professionals and women. He then contrasts the woman-centered "social" model of care with the large- scale "toxic" biomedical model. All the while he advocates for midwives' autonomy as they work in partnership with colleagues and with the women they serve.
This is an INVALUABLE guide for childbearing women, practitioners and obstetrical policy makers.

Working as a midwife in hospital meens negotiating the landmines of intervention with women to ensure that birth can be "normal". Denis Walsh examines the evidence for routine CTG monitoring, the labour progress model, active mamagement of third stage and definitions and management of blood loss etc to question our understanding of what is normal.
Current medical interventionalist models view birth as normal only in retrospect. Midwives understand that birthing women display many types of "normal". READ THIS BOOK AND START ASKING THE QUESTIONS OF YOURSELF AND YOUR PRACTICE. Do we really have the evidence for what we do? Is this kind of evidence able to allow for examination of womens experience of the interventions and their impact on their birthing? There is lots of work to be done to understand what is normal.

Excellent! Evidence based and easy to read, this book is a must-read for midwife students, midwives, physicians, nurses and all other women's health care providers! The author's candid style and earnest application of evidence will change your thinking (or reinforce your suspicions) about current obstetric practices.

With this guide to evidenced-based maternity care, Denis Walsh makes available research on every aspect of labor and birth care and presents it in a way that helps practitioners incorporate the latest evidence into practice. His chapters include "Practice recommendations" as well as "Questions for reflection" that will stimulate discussion in both the classroom and the clinical setting. While the title refers to this book as "a guide for midwives", it is equally useful for family doctors or obstetricians who attend births.