Improvements in the care of the pregnant woman and fetal patient during the birthing process have been a success story for modern obstetrics. Less than a century ago maternal mortality during labor was commonplace in most developed countries, and fetal mortality and morbidity were even more common. The keystone of modern obstetrics was the introduction of hospital and safe cesarean deliveries in the early 20th century. However, too much of a good thing can sometimes lead to other problems.

In their book Proactive Support of Labor, Drs Reuwer, Bruinse and Franx make an important contribution to modern obstetrics by providing a critical counterbalance to technologic interference in labor and delivery. The authors introduce the concept of “Proactive Support of Labor” as an acceptable alternative to traditional labor and delivery management in order to shorten labor and ultimately ensure a safer delivery. They propose that results of improved labor and delivery management should be evaluated not only in physical terms (e.g., reduced morbidity and mortality) but also in terms of emotion and patient satisfaction. This concept is designed to not only improve the overall outcome but also patient satisfaction.

We agree that the perspective provided in this book should be carefully considered by all providers of healthcare to women in labor. The call for humanistic and evidence based obstetric care in labor and delivery by including the emotional needs of women in labor should be embraced throughout the world.