Labor and Delivery Nursing: A Guide to Evidence-Based Practice

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This is an excellent book that provides a wealth of information on the practice of labor and delivery nursing. The authors are highly qualified and experienced obstetric nurses and the reading imparts a sense of wisdom, guidance, and “lessons learned” being passed on from experts in the field to the novice or proficient labor and delivery nurse. Any nurse with a desire to increase competence and confidence in the area of labor and delivery nursing will benefit greatly from the teaching provided in this evidence-based manual.

The book is divided into 10 chapters. Each chapter provides its own educational lesson and can easily be read in a single session. The learner is guided through all stages and phases of labor and delivery in a very thorough and organized manner. The important aspects associated with each stage of the birthing process are delineated, along with relevant anatomy and physiology and potential complications. Although this book is specifically directed toward the labor and delivery nurse, there are numerous passages that are relevant and applicable to all nurses.

The first chapter sets the tone for the book with a detailed discussion of the importance of clear and careful communication among health care providers. Throughout the book, there are numerous examples of proper documentation and communication techniques. The necessity of providing accurate and detailed nursing documentation is explained, as is the need for patient advocacy and following the chain of command when various issues arise. The value of a healthy work culture in ensuring good communication and patient-centered care also is emphasized. These are just a few examples of the abundant information that is applicable and essential for all nurses.

The information in the second chapter also is useful for all nurses who provide clinical care because it addresses patient assessment, which is an essential element of skilled nursing practice. The authors note that individualized assessments should include areas such as health literacy, cultural issues, age-specific concerns, possible substance or domestic abuse, body mass index, hydration status, infections and diseases (eg, diabetes, sexually transmitted diseases, hepatitis), and pain.

Although the pain management techniques recommended by the authors in chapter 4 are directly focused on the labor and delivery patient, they are easily transferred to a wide variety of patients. Many helpful nonpharmacologic suggestions are offered, such as aromatherapy, hydrotherapy, and controlled breathing, along with a discussion of traditional pharmacologic methods of pain management. The information provided regarding spinal-epidural anesthesia and analgesia commonly used for maternal pain relief is extremely relevant for perinatal nurses as well as perioperative and other nurses caring for patients who have received or are undergoing this type of anesthesia or analgesia.

As might be expected, there is a great deal of useful information relative to providing appropriate, evidence-based care for patients in all stages of labor and delivery. Chapters 5 through 9 offer an enormous amount of literature-supported detail relative to positions for labor and birth, fetal well-being, placental and umbilical cord pathology, the birth process, and vaginal and cesarean delivery. Each chapter of this manual contains many detailed pictures and diagrams, which provide additional clarification for the learner regarding the information presented.

The book concludes with a chapter describing the need for nursing care that addresses the psychological, spiritual, and cultural dimensions of the patient. The authors state that, “To be an effective care provider, nurses … need an open mind, an accepting attitude, hands-on skills, and a broad and deep understanding of the research … The best care will be evidenced-based.” This book is one that will function not only as an outstanding reference manual in the perinatal department, but also as an example of current, literature-supported practices for all nurses desiring to provide evidence-based care.

The authors of this column have no declared affiliations that could be perceived as posing potential conflicts of interest in the publication of this article.