"New to this edition are chapters describing the profession of midwifery, reproductive physiology, clinical genetics, and support for women in labor. Interwoven throughout is information on primary care, gynecology, maternity care, and neonatal care. With chapters written by a variety of expert midwives and an increased emphasis on reproductive anatomy and physiology, this new edition assists students and clinicians in understanding not only what to do but why. Updated to reflect evidence-based care, this edition also discusses the pathophysiology of various conditions in the context of normal changes in the reproductive cycle."--Publisher.

Part I: Midwifery. Chapter 1: The history and profession of midwifery in the United States. Definitions and practice ; Beliefs characterizing midwifery ; Early history of midwifery in the United States ; Factors leading to the decline of midwifery: Seventeenth to late nineteenth centuries ; The early twentieth century ; The "midwife problem" ; The start of nurse-midwifery ; The early nurse-midwifery education programs ; The 1940s and 1950s ; The 1960s ; The 1970s ; The 1980s ; The 1990s ; The 2000s ; The American College of Nurse-Midwives ; References ; Bibliography -- Chapter 2: Professional midwifery today. Introduction ; The professional paradigm: midwifery in the twenty-first century ; Evolution of the profession of midwifery ; Characteristics of the midwifery profession ; The professional: the exemplary midwife ; Midwifery within the U.S. healthcare system ; Professional ethics in midwifery ; Evidence for midwifery care ; Conclusion ; References ; Additional resources -- Chapter 3: International midwifery and safe motherhood. Introduction ; The health of women and children: the foundation for a nation's health ; Maternal mortality: the global situation ; Strategies designed to reduce maternal mortality ; Specific strategies for reducing global maternal and neonatal mortality ; Global partners involved in safe motherhood initiatives ; International midwifery ; Beyond borders: midwives working internationally ; Future trends and challenges in international midwifery ; Conclusion ; References. Part II: Primary care. Chapter 4: An introduction to the care of women. Midwife means "with woman" ; Communication ; Approaching the woman ; Collecting the medical history ; Review of systems ; The physical examination ; In-office laboratory testing ; Establishing a differential diagnosis: making an assessment ; Creating a plan ; Informed consent and shared decision making ; Cultural competence ; Conclusion ; References ; Additional resources -- Appendix 4A: Standard precautions -- Appendix 4B: Collecting a medical history -- Appendix 4C: The physical examination -- Appendix 4D: Breast examination -- Appendix 4E: Pelvic examination -- Appendix 4F: Collecting urinary, vaginal, cervical, and rectal specimens for testing and interpretation of saline and koh slides -- Chapter 5: Pharmacotherapeutics. Introduction ; The lexicon of pharmacology ; Drugs in modern society ; Pharmacotherapeutics in primary care ; Use of drugs during pregnancy ; Pharmaceuticals and breastfeeding ; Conclusion ; References -- Chapter 6: Nutrition. ; Nutrition and health ; Macronutrients ; Body's physiologic response to food intake ; Micronutrients ; Dietary patterns ; Nutrition in pregnancy ; Nutrition and selected conditions ; Special populations ; Conclusion ; References ; Additional resources -- Chapter 7: health promotion and health maintenance. introduction ; The midwife's role in health promotion ; Health promotion ; Health maintenance ; Health promotion and health maintenance in the context of the midwifery management process ; Conclusion ; References ; Additional resources ; Chapter 8: common conditions in primary care ; Primary care ; Hematologic conditions ; Cardiovascular conditions ; Conditions of the respiratory system ; Gastrointestinal disorders and abdominal pain ; Conditions of the genitourinary system ; Endocrine conditions ; Neurologic conditions ; Musculoskeletal disorders ; Dermatologic conditions ; Conclusion ; References -- Chapter 9: mental health conditions. mood disorders ; Depression ; Anxiety, stress, and obsessive-compulsive disorders ; Stress disorders ; Mental health disturbances related to the menstrual cycle ; Premenstrual dysphoric disorder ; Premenstrual exacerbation of psychiatric conditions ; Perinatal mental health disorders ; Mental illness in pregnancy ; Postpartum mood disorders ; Conclusion ; References -- Chapter 10: preconception care. Introduction ; History of preconception care ; Preconception care successes and barriers ; National guidelines: a "life-course perspective" ; Components of preconception care ; Reproductive life plan ; Risk identification ; Health promotion ; Health history and medical conditions ; Medication assessment ; Environment and workplace risks ; Preconception counseling for men ; Conclusion ; References ; Additional resources. Part III: Gynecology. -- Chapter 11: Anatomy and physiology of the female reproductive system. Introduction ; The breast ; The external female genitalia ; The internal female genitalia ; The fallopian tubes ; The ovaries ; The bony pelvis ; The obstetric pelvis ; The menstrual cycle: an introduction ; Steroidogenesis and the hypothalamus-pituitary-ovarian axis ; The ovarian cycle ; The endometrial cycle ; Conclusion ; References ; Additional resources -- Chapter 12: Menstrual cycle abnormalities. Introduction ; Amenorrhea ; Dysmenorrhea ; Abnormal uterine bleeding ; Menstrual cycle abnormalities and galactorrhea ; Conclusion ; References -- Appendix 12A: Endometrial biopsy -- Chapter 13: Gynecologic disorders. Introduction ; Abdominal and pelvic pain ; Pelvic masses ; Congenital uterine anomalies ; Pelvic floor conditions ; Special considerations in providing gynecologic care ; Cancer screening/diagnoses ; Conclusion ; References ; Additional resources -- Chapter 14: breast conditions. Breast development ; Breast screening ; Evaluation of breast symptoms ; Benign breast disorders ; Breast cancer ; Breast masses during pregnancy and lactation ; Conclusion ; References ; Additional resources -- Chapter 15: Reproductive tract and sexually transmitted infections. Introduction ; History and physical examination for vaginal symptoms and sexually transmitted infections ; Indications for sti screening ; Vaginitis ; Sexually transmitted infections ; Viral sexually transmitted infections ; Protozoal and parasitic infections ; Other infectious conditions spread by sexual contact ; Other conditions spread by sexual contact ; Communicating information about sexually transmitted infections ; Evaluation and follow-up ; References -- Chapter 16: Family planning. History of contraception ; Definitions ; Family planning counseling ; Emergency contraception ; Emerging trends/future contraceptive methods ; Conclusion ; References ; Additional resources -- Chapter 17: Nonhormonal contraception. Introduction ; Nonhormonal contraceptive methods ; Fertility awareness-based methods ; The intrauterine device ; Permanent contraception: sterilization ; Conclusion ; References -- Appendix 17A: Fitting diaphragms -- Appendix 17B: Procedure for IUD insertion -- Chapter 18: hormonal contraception. Introduction ; Evolution of hormonal methods ; Hormonal contraceptives: general considerations ; Midwifery management for women using hormonal contraceptives ; Short-acting reversible contraceptives ; Long-acting reversible contraceptives ; Conclusion ; References -- Chapter 19: Midlife, menopause, and beyond. Menopause: normal life process versus medical event ; Physiology and stages of reproductive aging ; Presentation of perimenopause and menopause ; Diagnosing menopause ; Lifestyle strategies for management of women with perimenopausal or menopausal symptoms ; Nonhormonal prescription options for vasomotor symptoms ; Hormonal prescription options for treatment of menopausal symptoms ; Complementary and alternative therapies during menopause ; The women's health initiative: a dramatic change in menopause practice ; Bone health, osteopenia, and osteoporosis ; Conclusion ; References ; Additional resources for further information about menopause and osteoporosis. Part IV: Antepartum. Chapter 20: Anatomy and physiology of pregnancy: placental, fetal, and maternal adaptations. Introduction ; The reproductive organs during pregnancy ; Hormones of pregnancy ; Fertilization and implantation ; The placenta ; Uteroplacental circulation ; The embryo and fetus ; Fetal growth ; Maternal anatomic and physiologic adaptations to pregnancy ; Fetopelvic relationships ; Conclusion ; References -- Chapter 21: Genetics. Introduction ; Foundations in genetics ; Genetic mutations and disorders ; Multifactorial inheritance: definition and common disorders ; Chromosomal disorders ; Birth defects, incidence, and risk identification ; Prenatal screening and diagnostic testing for genetic disorders ; Future trends in genetic testing ; Factors influencing screening, diagnostic testing, and decision making ; When genetic disorders are identified ; Genetic disorder prevention and risk reduction ; Financial, ethical, legal, and social issues in genetics ; Conclusion ; References ; Additional genetics resources -- Appendix 21A: Steps in constructing a three-generation pedigree -- Chapter 22: Prenatal care. Introduction ; Basic definitions ; Diagnosis of pregnancy and calculation of gestational age ; Maternal psychological adjustment ; The initial prenatal visit ; Subsequent prenatal visits ; Group prenatal care: centeringpregnancy ; Special populations ; Pregnancy-specific conditions ; Health promotion during pregnancy ; Health education during pregnancy ; Relief measures for common discomforts of pregnancy ; Conclusion ; References -- Appendix 22A: Obstetric abdominal examination -- Appendix 22B: Clinical pelvimetry -- Appendix 22C: Sample template for prenatal care visits -- Chapter 23: Obstetric complications in pregnancy. Introduction ; First trimester complications ; First trimester bleeding ; Ectopic pregnancy ; Hydatidiform mole ; Hyperemesis gravidarum ; Second trimester complications ; Cervical insufficiency ; Preterm labor: risk assessment and prenatal management ; Gestational diabetes ; Third trimester complications ; Gestational hypertension and preeclampsia ; Fetal growth restriction ; Polyhydramnios (hydramnios) ; Oligohydramnios ; Multiple gestation ; Management of pregnancy with known fetal anomalies ; Fetal death and stillbirth ; Female genital mutilation ; Techniques for fetal surveillance ; Conclusion ; References -- Appendix 23A: Auscultated acceleration test -- Chapter 24: Medical complications in pregnancy. Hematologic disorders in pregnancy ; Cardiovascular conditions: chronic hypertension in pregnancy ; Respiratory conditions ; Gastrointestinal conditions ; Genitourinary system ; Endocrine conditions ; Neurologic conditions ; Autoimmune disease in pregnancy ; Dermatoses of pregnancy ; Infectious diseases ; Conclusion ; References. Part V: Intrapartum. Chapter 25: Anatomy and physiology during labor and birth. Introduction ; Physiology of premonitory signs and symptoms of labor ; Onset of labor ; Uterine myometrial anatomy and physiology during labor ; Maternal pelvic anatomy related to labor and birth ; Cardinal movements of labor ; Maternal systemic adaptations in labor ; Fetal response to labor ; Conclusion ; References -- Chapter 26: The first stage of labor. Introduction ; Signs and symptoms of progress toward true labor onset ; Progress in the first stage of labor ; Midwifery management during the first stage of labor ; Components of midwifery care for laboring women ; Continuing evaluation of maternal well-being, fetal well-being, and labor progress ; Conclusion ; References ; Additional resources for normal birth -- Appendix 26A: Evaluation and diagnosis of ruptured membranes -- Chapter 27: Fetal assessment during labor. Introduction ; History of fetal heart rate monitoring ; Fetal physiology ; Fetal assessment during labor ; Fetal heart rate patterns ; Relationship between fetal heart rate patterns and newborn outcomes ; Interpretation and management of fetal heart rate patterns ; Conclusion ; References -- Appendix 27A: Intermittent auscultation during labor -- Appendix 27B: Attaching a fetal scalp electrode -- Chapter 28: Support for women in labor. Introduction ; Nature and experience of pain ; Women's experience of labor and birth ; Prenatal factors that influence labor pain ; General principles for comfort care and labor support ; Labor pain relief methods used in the united states ; Nonpharmacologic methods of mitigating pain ; Pharmacologic methods of mitigating pain ; Systemic medications ; Inhaled analgesics: 50:50 nitrous oxide/oxygen ; Neuraxial analgesia ; General anesthesia ; Conclusion ; References -- Appendix 28A: Injection of intradermal sterile water papules for relief of low back pain in labor -- Chapter 29: The second stage of labor and birth. Introduction ; Definition of second stage labor ; Normal course of the second stage of labor ; Abnormalities of the second stage of labor ; Assessment of maternal and fetal well-being in second stage labor ; Midwifery management of the second stage of labor ; Preparing for the birth ; Management of the birth ; Immediately following the birth ; Conclusion ; References -- Appendix 29A: Hand maneuvers for birth -- Appendix 29B: Genital tract injury: immediate postpartum inspection of the vulva, perineum, vagina, and cervix -- Appendix 29C: Local infiltration for laceration repair -- Appendix 29D: Pudendal block -- Appendix 29E: Repair of lacerations and episiotomy -- Chapter 30: Complications during labor and birth. Introduction ; Preterm labor/birth ; Post-term pregnancy ; Premature rupture of membranes ; Intra-amniotic infection (chorioamnionitis) ; Induction of labor ; Labor abnormalities ; Trial of labor after cesarean ; Intrapartum management for women with coexisting medical conditions ; Lethal anomalies and stillbirth ; Obstetric emergencies ; Intrapartum hemorrhage ; Shoulder dystocia ; Prolapsed umbilical cord ; Twin gestation ; Breech birth ; Deinfibulation for type iii female genital mutilation ; Conclusion ; References -- Appendix 30A: Shoulder dystocia -- Appendix 30B: Emergency interventions for umbilical cord prolapse -- Appendix 30C: Intrapartum management of twin gestation -- Appendix 30D: Breech birth -- Chapter 31: The third and fourth stages of labor. Introduction ; Physiology of the third stage of labor ; Techniques used in the management of third-stage labor ; Midwifery management of the third stage of labor ; The placenta ; The fourth stage of labor ; Complications of the third and fourth stages of labor ; Conclusion ; References -- Appendix 31A: Management of the third stage of labor -- Appendix 31B: Inspection of the umbilical cord, placenta, and membranes -- Appendix 31C: Manual removal of the placenta -- Appendix 31D: Initial management of uterine inversion -- Appendix 31E: Management of immediate postpartum hemorrhage -- Appendix 31F: Intrauterine exploration -- Appendix 31G: Sudden postpartum cardiovascular or neurologic emergencies -- Chapter 32: Birth in the home and birth center. Introduction ; Normal birth ; Characteristics of birth center and home birth ; Midwife-client relationships ; Initial visit during pregnancy ; Return visits ; The family's preparation for birth and the postpartum period ; The intrapartum period at home or in the birth center ; The early postpartum period and follow-up ; Maintaining safety ; Business aspects of out-of-hospital birth settings ; Conclusion ; References. Part VI: Postpartum. Chapter 33: Anatomy and physiology of postpartum. Introduction ; Postpartum hemostasis ; Reproductive organ involution ; Wound healing ; Postpartum physiology in nonreproductive organs ; Weight loss in the postpartum period ; Conclusion ; References -- Chapter 34: Postpartum care. Introduction ; Psychological adaption during the postpartum period ; Early postpartum period ; Late postpartum period ; Conclusion ; References ; Additional resources -- Appendix 34A: Physical examination during the early postpartum period -- Chapter 35: Postpartum complications. Introduction ; Puerperal morbidity ; Puerperal fever and puerperal infection ; Endometritis ; Wound infection ; Urinary tract infection and pyelonephritis ; Uterine subinvolution ; Delayed (secondary) postpartum hemorrhage ; Postpartum thrombophlebitis, deep vein thrombosis, and pulmonary embolism ; Postpartum thyroiditis and thyroid storm ; Postpartum preeclampsia/eclampsia ; Cultural influences on complications of the puerperium ; Conclusion ; References -- Chapter 36: Breastfeeding and the mother-newborn dyad. Breastfeeding: a call to action ; Benefits of breastfeeding ; Definitions ; Breastfeeding prevalence ; Economics of breastfeeding ; Promotion, protection, and support ; Anatomy and physiology of lactation ; Prenatal assessment ; Birth practices that have adverse effects on breastfeeding ; Birth practices that facilitate breastfeeding ; Breastfeeding: getting started ; Common breastfeeding problems ; Breastfeeding complications ; Breastfeeding discontinuation ; Contraindications for breastfeeding ; Formulations of breast milk substitutes ; References. Part VII: Newborn. Chapter 37: anatomy and physiology of the newborn. Immediate extrauterine transition ; Respiratory changes ; Circulatory changes ; Thermoregulation ; Glucose regulation ; The newborn immune system ; The newborn gastrointestinal tract ; The renal system ; Conclusion ; References -- Chapter 38: Examination of the newborn. Introduction ; Components of the newborn examination ; Approach to the newborn examination ; Newborn history ; Gestational age assessment ; Physical examination of the newborn ; Becoming confident at newborn physical examination -- Appendix 38A: Physical examination of the newborn -- Appendix 38B: Newborn resuscitation -- Chapter 39: Neonatal care. Introduction ; The first golden hour ; The first hours: initial newborn assessments and care ; The first hours: the newborn with an unexpected immediate health condition ; The first golden days: normal newborn behavior ; The first golden days of life: care of the healthy neonate ; Maternal conditions that influence newborn care ; Examination of the newborn ; The first golden month: primary care of the newborn ; Early recognition of clinically significant newborn conditions ; Conclusion ; References -- Index.