What Midwives Are Saying…

“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 Childbirth shines 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


What Doctors Are Saying…

“Optimal Care in Childbirth is a long overdue and very important contribution that will lead to a more safe, sane, and satisfying pregnancy care system.”

- Steven Calvin, MD, Clinical Associate Professor, Maternal-Fetal Medicine, University of Minnesota School of Medicine & Co-chair, Human Rights and Health Program, University of Minnesota School of Public Health

“This book is about evidence with attitude. Meticulously referenced, it addresses all the main issues that must be faced if our dysfunctional maternity care system is to be challenged and changed. The central debates in the field are dissected to allow the reader to understand why the existing methodologies often are incapable of disentangling the disputes, leaving the field open to powerful professional interest group biases and conflicts of interest. It is not pretty stuff but much needed.”

- Michael C. Klein, MD, CCFP, FAAP (Neonatal-Perinatal), FCFP,ABFP,FCPS
Emeritus Professor Family Practice and Pediatrics
Senior Scientist Emeritus
Centre Developmental Neurosciences & Child Health
Child and Family Research Institute
Vancouver, BC Canada


What Doulas and Childbirth Educators Are Saying…

“Exceptional for its academic excellence, broad perspective, and wisdom, this book provides an encyclopedic examination of the scientific literature on childbirth. Goer and Romano paint a grim picture as they guide us through the confusing maze of science, rhetoric, opinion, special interests, and clashing values that shape maternity care today. At the same time, their astute criticism reveals what it will take to fix our broken system. We must thank them for their courage and passion for truth. Their work will improve the beginnings of life for our youngest citizens. This should be a textbook for everyone in maternity care!

- Penny Simkin, PT, author of The Birth Partner: A Guide to Childbirth for Dads, Doulas, and all Other Labor Companions; co-author with Ruth Ancheta of The Labor Progress Handbook

“Romano and Goer have truly given us a gift in Optimal Care in Childbirth: The Case for a Physiologic Approach: a comprehensive, evidence-based blueprint for action. Generally speaking, this essential book examines the gap in maternity care between evidence-based optimal care and current best practice given by many maternity care practitioners. But that is just the tip of the iceberg!…It will renew and revitalize you and your birth work. I guarantee.” [Read the rest of this review.]

- Connie Livingston, BS, RN, LCCE, FACCE, CD(DONA), BDT, ICCE, Founder of Perinatal Education Associates


What Nurses Are Saying…

“Optimal Care in Childbirth presents compelling evidence for the value and importance of a physiologic approach to childbirth and provides a clear, exhaustive guide for making sense of the research in the context of the current maternity care system. This long awaited book is a marvel. It is a ‘must have’ resource not just for childbirth educators, nurses, obstetricians, and women, but for hospital administrators, insurance companies, and policy makers.”

- Judith Lothian, PhD, RN, LCCE, Seton Hall University College of Nursing


What Advocates, Researchers, and Reformers Are Saying…

An invaluable resource for those who want to reform maternity care! It rigorously and skillfully analyzes the evidence base for physiologic care and powerfully argues how the medical management model has gone wrong.”

- Diony Young, author and consultant in maternal health