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This latest edition of Dr. Harry Oxorn's text is the result of collaboration between numerous physicians in the Department of Obstetrics and Gynecology at the Ottawa Hospital. Although modern medicine relies heavily on science and technology, the most astute accoucheurs still practice the art of obstetrics embraced in this book. Much has changed, but much has remained the same. Although every chapter has been revised and refreshed, we've endeavored to stay true to the utilitarian spirit of the book that Dr. Oxorn intended. This textbook is not a treatise on theoretical evidence-based obstetrics that can only be practiced at tertiary centers; rather, it is a handbook of useful information for practitioners in the trenches who need real advice on how to manage real problems. New additions, such as a chapter on the challenges of obesity in pregnancy, descriptions of modern techniques for the management of postpartum hemorrhage, and an expanded treatment of multiples, refl ect the modernization of Dr. Oxorn's work.

It has always been our intention to bring this text into the twenty-first century while respecting its heritage. As such, we owe a great debt to the previous contributors for giving us such a solid foundation; their legacy resides both within these pages as well as in the halls of the labor wards in Ottawa.

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