“Henci Goer and Amy Romano have written a “must read” book for health care bureaucrats, policy advocates, and legislative aides; childbearing women; and childbirth health care providers alike. The authors delineate the medical management model from the physiologic care model and use the concept of “optimality” to analyze the evidence found in research to ascertain how well each model measures up against this standard. Comprehensive in the details of childbearing, controversial clinical issues are particular grist for their mill and no sacred cow of rationale is excluded from their scrutiny. The overwhelming evidence for achieving optimality is with the physiologic care model and midwife-led maternity care systems. Using careful and powerful writing, Goer and Romano mince no words in sharing their findings and provide the reader with the arguments needed to promulgate optimal care in childbirth.”

Helen Varney Burst, CNM, MSN, DHL (Hon.), FACNM, original author of Varney’s Midwifery, Past-President, American College of Nurse-Midwives, Professor Emeritus, Yale University School of Nursing

“Kudos to Henci Goer and Amy Romano, who have produced this comprehensive and authoritative review and analysis of what the obstetric evidence does and does not support. Given the soaring rates of medical intervention in birth, this case for an optimal approach could not be more timely!”

Ina May Gaskin, MA, CPM, PhD (Hon.)

Goer & Romano have given the maternity care community a gift in their robust examination and synthesis of the evidence supporting best ways to achieve optimal, physiologic birth for women and infants. The United States and the world are experiencing a cesarean explosion with potential short- and long-term health implications. This book will help clinicians and consumers consider the evidence and work together on shared decision-making about best approaches to maternity care.”

Holly Powell Kennedy, PhD, CNM, FACNM, FAAN, Varney Professor of Midwifery, Yale University

“As midwives we support transformation, both in our deeply personal work with mothers and babies and as advocates for a new vision for US maternity care. This book is a primer for success in both the professional and political arenas midwives navigate every day.”

Brynne Potter, CPM, North American Registry of Midwives Board of Directors & Founder of Private Practice, Intuitive Charting Software for Midwives

“Childbirth practices shape a culture in ways that no other influence can match. Optimal Care in Childbirthshines a clear, reasoned light on the inherent irrationality and harmful practices of our current medical management approach to birth in the U.S., and offers a handbook of hope, tools, and skills to change agents working to reclaim the humanity of birth.”

Mary Lawlor, CPM, LM, MA, Executive Director, National Association of Certified Professional Midwives (NACPM)

“There is no question that everyone wants “the best” for women during the process of giving birth. What is in question is “what is the best.” Goer and Romano provide women and maternity care providers with an invaluable resource to help answer that question. Optimal Care in Childbirth: The Case for a Physiologic Approach provides a comprehensive review of the science related to birth care practices while also highlighting the questions that are still unanswered. They move between the larger system issues that we as a society need to address to improve maternity care while also offering step by step actions a woman and her partner can take to have an optimal physiological birth experience. This balance between the mini-reviews of the science, the practical steps women and health care providers can take to support physiological birth, and the honesty in how they address the complex and dynamic nature of giving birth in the US, makes this book a must read for everyone involved in providing maternity care services. It is also a must read for women and their partners as they plan for the birth of their child.”

Lisa Kane Low, PhD, CNM, FACNM, University of Michigan