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Cella Director of Product Management: Amanda Martin Product Manager: Teresa Reilly Product Assistant: Anna-Maria Forger Production Editor: Vanessa Richards Marketing Communications Manager: Katie Hennessy Product Fulfillment Manager: Wendy Kilborn Composition: S4Carlisle Publishing Services Cover Design: Kristin E. Parker Rights & Media Specialists: Wes DeShano, John Rusk Media Development Editor: Troy Liston Cover Image (Title Page, Part Opener, Chapter Opener): © hakkiarslan/iStock/Getty Images Plus/Getty Printing and Binding: Edwards Brothers Malloy Cover Printing: Edwards Brothers Malloy Library of Congress Cataloging-in-Publication Data Names: King, Tekoa L., editor. | Brucker, Mary C., editor. | Osborne, Kathryn (Nurse-midwife), editor. | Jevitt, Cecilia, editor. Title: Varney’s midwifery / edited by Tekoa King, Mary Brucker, Kathryn Osborne, Cecilia Jevitt. Other titles: Midwifery Description: Sixth edition. | Burlington, Massachusetts: Jones & Bartlett Learning, [2019] | Includes bibliographical references and index. Identifiers: LCCN 2017060855 | eISBN 9781284127966 Subjects: | MESH: Midwifery | Nurse Midwives | Obstetric Nursing | Pregnancy | Pregnancy Complications Classification: LCC RG950 | NLM WY 157 | DDC 618.2--dc23 LC record available at https://lccn.loc.gov/2017060855 6048 Printed in the United States of America 22 21 20 19 18 10 9 8 7 6 5 4 3 2 1 Brief Contents Part I Midwifery Chapter 1 History of Midwifery in the United States Chapter 2 Professional Midwifery Today Chapter 3 Midwifery: Clients, Context, and Care Part II Midwives as Primary Care Providers Chapter 4 Introduction to the Care of Women Chapter 5 Health Promotion Across the Lifespan Chapter 6 Common Conditions in Primary Care Chapter 7 Nutrition Chapter 8 Mental Health Conditions Chapter 9 Pharmacotherapeutics Part III Gynecology Chapter 10 Anatomy and Physiology of the Female Reproductive System Chapter 11 Menstrual Cycle Abnormalities Chapter 12 Gynecologic Disorders Chapter 13 Breast Conditions Chapter 14 Reproductive Tract and Sexually Transmitted Infections Chapter 15 Family Planning Chapter 16 Nonhormonal Contraception Chapter 17 Hormonal Contraception Chapter 18 Midlife, Menopause, and Beyond Part IV Antepartum Chapter 19 Anatomy and Physiology of Pregnancy Chapter 20 Genetics Chapter 21 Prenatal Care Chapter 22 Pregnancy-Related Conditions Chapter 23 Medical Complications in Pregnancy Part V Intrapartum Chapter 24 Anatomy and Physiology During Labor and Birth Chapter 25 First Stage of Labor Chapter 26 Fetal Assessment During Labor Chapter 27 Support for Women During Labor Chapter 28 Second Stage of Labor and Birth Chapter 29 Complications During Labor and Birth Chapter 30 Third Stage of Labor Chapter 31 Birth in the Home and Birth Center Part VI Postpartum Chapter 32 Anatomy and Physiology of Postpartum Chapter 33 Postpartum Care Chapter 34 Postpartum Complications Chapter 35 Breastfeeding and the Mother–Newborn Dyad Part VII Newborn Chapter 36 Anatomy and Physiology of the Newborn Chapter 37 Examination of the Newborn Chapter 38 Neonatal Care Index Contents Preface Acknowledgments Contributors Part I Midwifery With Introduction by Holly Powell Kennedy Chapter 1 History of Midwifery in the United States Anne Z. Cockerham Introduction Evolution of Nurse-Midwifery’s Professional Image and Organization Evolution of Legal Practice Authority for Nurse-Midwives Evolution of the Midwifery Scope of Practice Caring for Underserved Populations Place of Birth Nurse-Midwife/Physician Collaboration: Opportunities and Challenges Documenting the Outcomes of Midwifery Care and Midwifery Research Nurse-Midwifery Education Conclusion References Chapter 2 Professional Midwifery Today Deanne R. Williams Introduction The Profession of Midwifery Types of Midwives Core Competencies Hallmarks of Midwifery Accreditation Certification Licensure and Regulation Code of Ethics Midwives in the United States Scope of Practice Practice Patterns Other Roles for the Modern Midwife Midwifery as a Worldwide Profession Conclusion Resources References Appendix 2A Worksheet for Engaging in Global Midwifery Joyce E. Thompson Chapter 3 Midwifery: Clients, Context, and Care Jyesha Wren Serbin, Simon Adriane Ellis, Elizabeth Donnelly, and Kim Q. Dau with Betty Jane Watts Carrington, Heather Clarke, Carolyn Curtis, Nicolle L. Gonzales, Patricia O. Loftman, Felina M. Ortiz, M. Susan Stemmler, and Karline Wilson-Mitchell Introduction Social Structure: Power, Privilege, and Bias Social Determinants of Health and Health Disparities Socioeconomic Status Racial Disparities Sexual Orientation and Gender Identity Gender-Based Violence Techniques and Tools to Address Health Disparities in Midwifery Practice Conclusion Resources References Appendix 3A Reproductive Health Statistics Mary C. Brucker and Tekoa L. King Part II Midwives as Primary Care Providers With Introduction by Lisa L. Paine Chapter 4 Introduction to the Care of Women Jan M. Kriebs Midwife Means “With Woman” Communication Approaching the Woman Collecting the Health History The Physical Examination In-Office Laboratory Testing Establishing a Differential Diagnosis: Making an Assessment Designing a Plan Conclusion Resources References Appendix 4A Standard Precautions Jan M. Kriebs Appendix 4B Collecting a Health History Jan M. Kriebs Appendix 4C The Physical Examination Jan M. Kriebs Appendix 4D Breast Examination Jan M. Kriebs Appendix 4E Pelvic Examination Jan M. Kriebs Appendix 4F Collecting Urinary, Vaginal, Cervical, and Rectal Specimens for Testing and Interpretation of Saline and KOH Slides Jan M. Kriebs Chapter 5 Health Promotion Across the Lifespan Kathryn Osborne Introduction Health Promotion: Primary Prevention Evidence-Based Counseling Interventions Immunizations Health Maintenance: Secondary Prevention Reproductive Life Planning and Preconception Care Conclusion Resources References Appendix 5A Preconception Care Visit Mary C. Brucker and Mary Ann Faucher Chapter 6 Common Conditions in Primary Care Jan M. Kriebs and Barbara K. Hackley Introduction Primary Care Hematologic Conditions Cardiovascular Conditions Respiratory Conditions Gastrointestinal Disorders and Abdominal Pain Hepatitis Conditions of the Genitourinary System Endocrine Conditions Neurologic Conditions Musculoskeletal Disorders Dermatologic Conditions Substance Use: Screening and Counseling Conclusion Resources References Chapter 7 Nutrition Mary K. Barger Nutrition and Health Nomenclature for Nutritional Standards Macronutrients Fats Physiologic Response to Food Intake Micronutrients: Vitamins and Minerals Fat-Soluble Vitamins