Category Archives: Book Reviews

19 Jun

Book Review: Optimal Care in Childbirth, by Henci Goer and Amy Romano

This dense and fascinating book presents a huge amount of evidence and a highly articulate argument for a physiological model of birth, starting from the premise that pregnancy and birth are healthy, normal experiences for the majority of women, and only where risk exists, does medical management become appropriate.

This approach fits nicely with my own philosophy of pregnancy and birth, and is well-supported by short analyses of the research in each chapter. Other reviewers have pointed out that the evidence is somewhat cherry-picked, as is always the way in the context of books on birth. It seems to be categorically impossible to have a truly objective reading of the evidence on this subject, and few people with any real knowledge seem to occupy a middle ground on the spectrum from hardline birth skeptics who can only allow the medical model, and advocates of straightforward physiological birth. Both groups tend to be very blinkered about research that contradicts their point of view.

Optimal Care in Childbirth gives a good insight into the source of this deep opposition between the two philosophies. Within the medical model, pregnancy and birth are presented as intrinsically dangerous and difficult. The historical background to this assumption is well documented. In the 21st Century western world, overall levels of risk, particularly to the mother, are very low; and this results in a narrow focus where almost the sole positive outcome to be achieved is a live baby and mother. Strategies are therefore devised to minimise the maximum potential risks, and preventative procedures become routine. This leads to an assumption that the medical approach is the norm, which has a knock-on effect on the research available. The more women who give birth by caesarean section, for example, the greater the belief in the medical community that birth is difficult and dangerous, and the more deskilled midwifery becomes.

There is no doubt that childbirth is complex, variable, and human; and the outcomes of childbirth are soft, complex and variable too. Goer and Romano define the optimal outcome as:

“the highest probability of spontaneous birth of a healthy baby to a healthy mother who feels pleased with herself and her caregivers, ready for the challenges of motherhood, attached to her baby, and who goes on to breastfeed successfully.” [p21]

However since the language and thinking of research is based in the medical model, the basic assumption is that non-intervention in childbirth equals risk, rather than the other way around. Optimal Care in Childbirth recommends reserving medical intervention for those women who would genuinely face greater difficulty without it, rather than protocols that offer it routinely in order to reduce risks that are already small.

The chapters of the book cover all the main topics of relevance to anyone working in childbirth (it is probably not a book aimed at pregnant women, who might get similar but more accessible information from Ina May Gaskin’s books). The chapters cover caesarean birth, induction of labour, care during labour, birth, postnatal care, and midwifery practice. Each chapter includes a mini-review of research and strategies for optimal care. It is a very practical book and an important resource for midwives, obstetricians, doulas and antenatal educators.

22 Oct

Book Review: Birth Trauma by Kim Thomas

Birth Trauma: A Guide for You, Your Friends and Family to Coping with Post-Traumatic Stress Disorder Following Birth

A year ago I listened to Sheila Kitzinger talk about her Birth Crisis Network, which she set up to help women who had suffered a traumatic birth. She gave examples of some of the things said by women for whom childbirth was not a happy or straightforward event, and I was shocked at the language and strength of feeling expressed. Only in recent years has it been recognised that a traumatic birth experience can give rise to post-traumatic stress disorder (PTSD) in women, and there are still few accessible resources for them or the people supporting them. Read More →

19 Sep

Book Review: Theo Gallas Always Gets Her Man, by Kristen Panzer

Theo Gallas Always Gets Her Man – Kristen Panzer

This was a free download, in which a trainee lactation consultant juggles family, a neighbourhood mystery, and voluntary breastfeeding support of an unusually medicalised nature. It is not clear how or when she does her training, but she shares her knowledge readily and always carries a pair of latex gloves with her with which to do a quick mouth exam (not something a fully qualified and experienced NCT Breastfeeding Counsellor is likely to do). Read More →

01 Jul

Book Review: BabyCalm – A guide for calmer babies & happier parents

This is a book absolutely loaded with practical information and advice, written by Sarah Ockwell-Smith, the founder of BabyCalm™. The focus of the book is extremely baby-centred, and the chapter on Understanding Your Baby’s Needs is excellent, with good clear explanations and examples to help the reader empathise with the baby and use this knowledge to find easy and gentle ways to parent.

I can identify with this position, and found myself nodding in agreement through paragraph after paragraph, particularly in the chapter about maternal instinct, which was disappointingly short, but was picked up again in a later chapter on the transition to motherhood.

There are a number of very practical sections, notably the excellent and highly accessible description of ‘babywearing;’ and although I have personal reservations about the use of that word as a verb, Ockwell-Smith does point out that it was coined by the revered Dr Sears, not by her. I would have no such reservations about using the book to show a client how to use a wrap sling, and found it more helpful than the various YouTube videos I have looked at in the past. Similarly the baby massage instructions are clear and easy to follow.

Acknowledging that sleep is a major issue for many new parents, three of the twelve chapters are given over to helping parents to manage it, and her description of normal baby sleep and the mismatch of new parents’ expectations is very clear and useful, and there are some good tips in her ten ways to encourage more sleep at night.

The section on breastfeeding is well based within the evidence about how breastfeeding works, with the exception of the paragraphs about lactose intolerance, which are both confused and confusing. (Symptoms of both cow’s milk protein allergy, and lactose intolerance are given, followed by a personal anecdote describing the symptoms attributed to CMP allergy, but which were apparently resolved by giving lactose-free formula. The chapter was absolutely adequate without the anecdote). Most of the book is applicable to formula feeding mothers, but I am not sure that this is made quite clear enough.

The book is very well-referenced, although in places it is not clear how the studies quoted support the point being made. I was concerned that the single study quoted in support of chiropractic treatment was written by an enthusiastic chiropractor, and may not have been entirely free of bias. The discussion of chiropractic should cover the potential risks, just as the section on dummies does. Ockwell-Smith plunders the related literature and also packs the text with real stories from mothers who give examples of how BabyCalm™ has helped them. For me there was a little bit too much in the way of anecdote, but perhaps that’s because I’ve read so many of these books, and they may well trigger lightbulb moments for new parents trying to find their place in their new worlds. Stylistically, I did not enjoy the first person voice and felt that Ockwell-Smith shares too much of her own experience, which could possibly come across as a little more directive than is intended.

I enjoyed reading BabyCalm and it helped me to reflect on how I talk to new and expectant parents, particularly about advice and instinct. I would be more likely to recommend it to people who I know to be inclined towards attachment parenting, as I don’t think it has universal appeal, but it’s definitely one I’m happy to have in my library.

[Disclosure: I was sent a free copy of this book by publisher Piatkus]

20 Jun

Book Review: The Hormone of Closeness, by Kerstin Uvnas Moberg

The Hormone of Closeness: The role of oxytocin in relationships, is the second book I’ve read by Kerstin Uvnas Moberg on the subject of oxytocin, the hormone involved in childbirth, bonding and so much more.

Moberg posits an explanation of attachment theory wherein oxytocin underpins the child’s sense of security through enhanced wellbeing, increased calm, and a sense of satisfaction. She terms the innate and evolutionarily necessary need for closeness and contact with others as “skin hunger,” to equate it with hunger for food. This casts touch and its effects in a useful new light, showing how breastfeeding is about so much more than the transfer of milk, for the mother and the baby.

While much of the evidence in the book is drawn from lab studies on rats, her arguments are logical and compelling. Lay readers might skip the scientific stuff about what goes on in the brain, and read instead the fascinating description of the mother-baby relationship in the first place, which is then drawn into the wider context of our social interactions, stress levels, and the way we live.

Looking forward to the implications of the development of synthetic oxytocin, Moberg acknowledges that artificially increasing oxytocin levels, thereby increasing the tendency to trust, might not always be a good thing, particularly in a setting where we would not naturally be trusting. Evidently it would be better for the individual, and for society as a whole, to find natural ways to increase the world’s oxytocin levels. To illustrate this, she looks at the doula phenomenon, where a trusted woman present at birth can have a positive outcome, by allowing the birthing mother to tune into her body and allow levels of oxytocin to rise, facilitating labour and bonding with the new baby.

She finishes by looking at the possible consequences of our increasingly separate lives, and with a call on behalf of future generations to consider how to bring back social closeness, that “all of us on earth could live in peace and harmony with one another.” [p157]. This is an enlightening and affirming read.

***

To order The Hormone of Closeness with a 25% discount, just follow the link and use the discount code KH25 at the checkout.

[Disclosure: review copy provided by publisher]

30 May

Book Review: Baby Management for Men, by Henk Hanssen

Author Henk Hanssen claims that fatherhood is his favourite subject, and a real sense of fun comes across in this warm and accessible little baby manual.

In this book, the father is the consummate manager. The family is your enterprise, the mother your producer, the baby your product. [p10]

Heavy on the business-speak and technical jargon, it might not appeal across the board, but beneath the veneer of gentle silliness, the book is packed with practical information. It addresses how the new father’s life will change, how to approach his employer with requests for paternity leave and flexible working hours, and directs the him to think about the kind of father he wants to be. It then goes on to describe in detail the baby’s appearance, likely behaviour, and maintenance required in the first year or so.

You might pick up a book with the title “Baby Management” expecting a rigid, parents-in-charge approach; in fact I would place this well towards the attachment parenting end of the spectrum. Hanssen encourages dads to be hands-on, and quotes evidence to show the benefits of an involved, engaged father, for the whole family.

My few criticisms of the book would include a raised eyebrow that the feeding section starts with expressing before actually addressing the subject of breastfeeding. Granted that’s because the focus is on how a dad can be involved with this, but I would rather see the emphasis on supporting the mother to establish breastfeeding first; there are lots of ways dads can help with this. Hanssen erroneously states that breastmilk can be kept in the fridge for up to 72 hours; most reliable sources state 5-7 days. Other than that, the section dealing with feeding is almost entirely accurate. Sadly when it comes to introducing solids, the advice given is rather old-fashioned purees-only approach.

The section on growth and development is particularly fascinating, and the book is well-referenced. I wouldn’t hesitate to recommend it to fathers-to-be.

*****
To order Baby Management for Men with a 25% discount, just follow the link and use the discount code KH25 at the checkout.

29 Apr

Book Review: Talking with children about things that matter, by Sheila and Celia Kitzinger

Talking with children about things that matter by Sheila and Celia Kitzinger, is a wide-ranging discussion about the big issues that bother contemporary parents. Although it was written in 2000, and therefore lacks that important chapter on social media and the internet, the contents of this book are highly applicable to the modern family.

The Kitzingers have surveyed parents and reviewed the literature to look into some really big topics, examining the way parents attempt to instil their own values in their children. The book therefore caused this reader to reflect on her own values and upbringing, and feel both optimistic and pessimistic about my son’s childhood.

Pessimistic because this world seems so much bigger and scarier than the one I grew up in, and the task of fitting my boy with tools and strategies seems insurmountable. In a week when teenagers have bombed marathon runners and a world famous children’s entertainer has been arrested for sexually abusing a child, how do I protect him, and how do I send him out there fit to do good, not harm?

Optimistic because many of the issues I find sticky, such as prejudice, sexuality and the environment, seem more openly and easily tackled by his generation. He takes for granted that men can love other men, that skin colour is no more important than hair colour, and that everyone recycles. That doesn’t mean my work here is done, but we’re off to a good start.

This is not a how-to book, but it opens up new perspectives as well as reviewing some traditional points of view such as the value put on an “obedient” child. It’s sometimes helpful to remember that a child who questions authority as a matter of course is perhaps in a safer place than one who always does as he is told. Especially when you want him to put the lego away and put his shoes on for school.

I would have liked the book to go further on the topic of sexuality, and to have explored the implications of an atheist upbringing in more detail. I closed the book with some deep thoughts and intentions about how I can include my son in discussion, not shelter him from the news, and somehow help him to understand how privileged he is. I don’t have the answers to any of this, but I have a few more clues.

15 Jan

Book Review: Bumpology, by Linda Geddes

Bumpology is an attractive and accessible book with a very clear and logical layout, which compensates for the lack of an index. It is as easy to dip into as it is to read from cover to cover; I know because I did both.

This is a marvellously comprehensive collection of research evidence and occasional comment upon the lack of research evidence, for all the advice and received wisdom relating to pregnancy, birth and early parenthood. As Geddes says, the science is out there, but it often takes some digging to find it.

Geddes looks at the big issues such as place of birth, breastfeeding, and all those things you’re told you can’t eat during pregnancy; as well as bringing in some colourful sections on how the growing baby develops in the womb, what senses function from birth, and the role of newborn reflexes. This in itself is a useful part of learning to empathise with the baby, and might influence parenting choices.

I am used to reading far more dogmatic books (from all over the birth and parenting spectrum), so this measured tone is very refreshing. Research in this area on the whole appears to be very thin, often studies are very small or based on the behaviour of lab animals. The book does not offer many definitive answers, but its general message is not to take advice for granted, since much of what we are told from the moment we even start to think about having a baby has no basis in fact. This very important point was made by Octavia Wiseman in a recent Midirs article (July/August 2012:p22), pointing out that much health advice is risk-averse, undermining parental choice, and that “explaining to women the limitation of our evidence base is the first step to take when asking them to make ‘informed’ choices.”

It is lovely that the text is scattered with anecdotes about the author’s personal experience, but for the most part this book is about facts not feelings. It largely ignores ‘soft’ aspects such as how parents feel about risk, and how mothers experience birth and early motherhood. Statistical comparisons of different aspects of birth look at outcomes and define those in terms of health of the baby and mother, taking little account of how women feel during and after the experience. For example lying down or being mobile during labour may make no difference to the outcome in statistical terms, but different women may experience these scenarios as more or less positive. Lying down in a room full of medical staff may feel disempowering; a woman being made to walk around may feel bullied. Working with parents both antenatally and postnatally, I know that scientific evidence may not always be the most important factor when making decisions. A good example of this would be the decision to share a bed with your baby: whether, according to various studies, this increases the risk of cot death; or whether it increases your child’s self-esteem, are less likely to influence the decision to bedshare than the fact that it might just be easier not to have to get up in the night. This does not, of course, detract from the fact that parents can and should be made aware of the evidence in order to make an informed decision; and to be fair, Geddes does not set out to explore the qualitative aspects of parenthood, but to present the facts and figures, and bust the myths: a very worthwhile mission.

I would recommend Bumpology to anyone expecting a baby, but I think it is also essential reading for anyone working with parents, antenatally or postnatally. It is so important for us to get our facts right, to counter the myths and enable parents to be confident in their decision making. Very few of the books I’ve seen are so robustly evidence-based, and an awful lot of people working with parents will repeat advice without giving any critical thought either to the evidence behind it, or the effect it might have in an individual situation.

Bumpology Blog
Sense About Science
Linda Geddes on Radio 4’s Today Programme with Belinda Phipps, CEO of NCT

14 Dec

Book Review: Feed Yourself, Feed Your Family

Feed Yourself Feed Your Family is an attractive La Leche League book packed with information and useful tips. The chapters are ordered chronologically, covering pregnancy, new parenthood/breastfeeding, starting solids, and feeding a family. Each chapter includes a selection of recipes considered appropriate for that particular chapter of your life.

I was concerned that a chapter on eating for breastfeeding would fall into the trap of implying that breastfeeding is demanding if you don’t eat special food, but in fact the book explicitly states that this is not the case (however it does mention the need for 350 extra calories, which is not supported by evidence). This section is brimming with suggestions for food you can eat with one hand, and food you can get other people to cook for you. I especially liked the comment that “you are passing on your culture through your milk,” (p68) and have quoted that in antenatal classes and see the parents nodding.

The book has a slightly american tone, although it’s clear that much of it has been ‘translated’ into British English. Some of the food standards given are american, though this doesn’t detract from the clear, factual approach. My biggest concern with the book was the amount of salt added to almost every recipe, some of which included salt in the cooking, again before tasting, and then a garnish of bacon. The Starting Solids section could have had more emphasis on baby-led weaning, good finger foods, and how to work family meals that baby can eat too.

I didn’t think I could review a recipe book without trying out some of the recipes, so we tried five of them last week. Here’s how it went:

Monday
The Slow Cooker Split Pea Soup (p182) was very convenient for such a busy day; all the ingredients went into the slow cooker at lunchtime, and it just smelled more and more delicious over the course of the afternoon. Recipe books for me are inspiration rather than instruction, so most things get altered in some way. I added pancetta to this vegetarian recipe, to make it more acceptable to my partner and son, both of whom like veggie food but are sometimes a bit tentative when it comes to pulses. The soup went down an absolute treat, and there was enough left for lunch next day. Both of them said they would like me to make it again.

Tuesday
Tortilla Pie with Black Beans (p48) was another hit. This was tasty and cheesy, though it was a mistake for me to plan it for swimming night when I had one hour to cook and eat before rushing out to teach. This vegetarian dish slipped through the net no problem, though it was suggested that we could try it with chicken as well.

Wednesday
We were less enthusiastic about the Chicken & Sugar Snap Pea Saute, which seemed like an odd combination of nice things that didn’t really go together. It was also quite tricky to figure out what would go with this, as it didn’t lend itself well to pasta or rice, so ended up being served with chips.

Thursday
The plan was to make Froelich Family Rice (p137), however on reviewing the recipe at 5pm on Thursday I realised that it involved over an hour of cooking just to produce minced beef with rice. So I’m afraid I cheated completely, got out a packet of rice with vegetables, and cooked up the beef with some herbs, mushrooms and tomatoes, and mixed it all together. The end result was much the same, and they just stopped short of licking the bowl clean.

Friday
I try to include fish in our diet every week, despite not really liking it much myself, so on Friday I made the Fish Chowder (p229), using white fish instead of salmon which I cannot stand. This was the added-saltiest of all the recipes I tried, with salt added twice in the cooking as well as a stock cube and a bacon garnish. This seriously undermined the promise that the book is giving the reader “a blueprint for a lifetime of healthy meals” (p8). As I had forgotten to get the bacon out of the freezer, this was a moot point. My partner and son enjoyed the chowder, though my son as usual when bread is available did mostly eat the bread. I tolerated it and felt virtuous.

I would recommend this book because every chapter there has sensible information and guidance, including practical ideas for cooking while your baby or toddler is around. I would not go out and buy it just for the recipes.

*****
To order Feed Yourself Feed Your Family with a 25% discount, just follow the link and use the discount code KH25 at the checkout.