Book Reviews | Motherworldly

05 Dec

Book Review: Vaginal Birth After Caesarean

Vaginal Birth After Caesarean: The VBAC Handbook, by Helen Churchill and Wendy Savage, is a neat little book absolutely packed with useful information for mothers considering a VBAC, and those supporting them.

It is worth reading just for its forthright introduction explaining exactly why the authors choose not to adopt the tentative and controlling jargon often used by health professionals. The careful use of language in the book is in itself empowering.

Reading this book, I learned that 70-80% of VBACs are successful; that the risk of VBAC is lower than the risk of a planned Caesarean; and that the reasons commonly given not to “try” to have a VBAC do not appear to be evidenced across the board. Even the section dealing with higher risk groups shows that in most cases a VBAC can be possible.

The second part of the book includes several VBAC stories, not all of which were successful; however the stories demonstrate and affirm the wide range of experience even within this segment of birth and labour.

This is a useful and succinct guide, and I highly recommend it.

*****
To order aginal Birth After Caesarean with a 25% discount, just follow the link and use the discount code KH25 at the checkout.

07 Nov

Book Review: Confident Birth, by Susanna Heli

Confident Birth is an attractive book with a well-argued premise that empowering women with confidence in their own bodies and a good understanding of what happens during birth is a deeply positive move. Heli asks why we should be so afraid of childbirth, when maternity care has never been better; perhaps a quick dip into Birth & Sex would provide some insight: Kitzinger points out that we may have medically safer outcomes, but the psychological experience of contemporary childbirth may be something to fear. Heli focuses on the modern expectation of painless instant gratification in a consumer society, and explores the role of pain in labour, to help women develop tools and strategies for listening to their bodies and making positive decisions.

The first section of the book explores our attitude to pain and childbirth, with some exercises for the pregnant women, and short birth stories to illustrate her points. The second section offers four tools for coping with pain in labour, and the third section offers useful guidelines for the support person.

Confident Birth is aimed at the pregnant woman who wishes to prepare herself for a positive experience of birth. It uses language of empowerment and trust in the body and the instincts. It skirts the mystical, and while occasionally idealising labour (for example, describing it as “something to deepen our emotional intelligence” p.19), Heli does not demonise intervention. The gentle, encouraging tone makes it highly suitable for expectant parents; there is a good clear description of what labour is actually like, including physical and emotional sensations, and what the woman might need at different stages. It would also make an excellent handbook for a birth doula.

*****

To order Confident Birth with a 25% discount, just follow the link and use the discount code KH25 at the checkout.

02 Nov

I’ll have what she’s having: A review of Birth & Sex by Sheila Kitzinger

I bought Birth & Sex after hearing Sheila Kitzinger speak with an energetic passion that belies her frailty, a few weeks ago; the talk was part revision of the history of obstetrics, and many parts eye-opener.

A few days later I read on a skeptical website a description of orgasmic birth as “the ultimate first world problem.” [Deliberately unattributed]: making women feel guilty for not having an orgasm during labour. It’s that familiar argument that informing people about how things could be is mistaken for setting impossible aspirational targets for all women. Throughout the book, Kitzinger dips into history, revealing how birth has become depersonalised, the mother and her needs sidelined, and the only goal a healthy baby.

After a fascinating chapter on genital anatomy and an exploration of sex in pregnancy, she goes on to explain the processes that impact on a woman’s experience of labour. She is not telling women that they should have an orgasm during birth, any more than that they should have an orgasm every time they have sex; but describing conditions which it is often in the woman’s power to create, that allow her to behave spontaneously. In fact the comparison with having sex is instructive, since goal-oriented sex is likely to be less satisfying than loving, fun, comfortable, spontaneous and uninhibited sex, all of which are applicable to birth.

Kitzinger shows how other cultures celebrate birth movements, for example in north african bellydancing; but how the gradual introduction of a bed into the birth environment forces women to accept a more passive role, and has gradually led to a production line approach, “without wasting doctors’ time, and free of any female emotions that might complicate the process.” [p.69]

She goes on to explore the use of language around birth, rooting this right back in the usurpation of female mother goddesses by a male creator, taking the power of fertility away from women. In modern terms, the medical language used to describe birth using the terminology of risk and words like “delivery” put the power in the hands of the doctors. The language used by women following a traumatic birth is significantly similar to that used by rape victims; I have heard examples of this myself and have to ask if empowering and informing women can really be a bad thing.

With a slightly disappointingly small section on breastfeeding, the book ends with a discussion of sex after childbirth and how this might be impacted by a traumatic, violating experience or a positive birth that can enhance the way a woman feels about her own body. Kitzinger also considers the impact of the birth on a woman’s partner and his or her feelings about sex; along with the impact of the transition to parenthood. I love her description of the first year after birth as “chaos and glory” for the couple [p.148].

Birth & Sex does not seek to demonise intervention, but asks for perspective in its use, and reminds us that birth is a complex psychosexual experience with the potential to be life-enhancing. In the prevailing culture, how much choice do women really have? This book takes on one small segment of a society in which women’s bodies are still objectified and their minds still belittled, to an astonishing extent. To deny women this information is to deny them choice and consent in the way they live and labour.

*****

To order Birth & Sex with a 25% discount, just follow the link and use the discount code KH25 at the checkout.

10 Sep

Book Review: Toxic Childhood, by Sue Palmer

I picked this book up for £1 at Wokingham NCT’s Nearly New Sale, purely out of curiosity. I would say that I have entirely grown out of my organic/green parenting frenzy, partly through poverty and partly from being exposed to science debunking quite a lot of it.

Palmer does state in her preface that the book is largely her own opinion based on largely qualitative research and extensive interviews. This comes across very clearly throughout the text, and may alienate a lot of parents who choose not to follow her highly directive recommendations.

The main message of the book is that childhood ain’t what it used to be, and everyone would be much happier if our kids roamed free in the fields until teatime, then feasted on vegetables from the allotment and played wholesome games until they went to bed. Palmer develops her arguments well, supports them with a wealth of anecdote, and offers suggestions for detoxing childhood both at a family level and at a policy level. This is all very well-meant, but the parents who read this book are quite probably those who already give some thought to things like the effects of TV and junk food on their children. However I feel that the Brave Old World solution is not the right one for my family, and I worry when books dictate parenting styles without leaving room for individual circumstances and inclination. The TV, the internet, junk food and the dangerous streets are realities that our children have to learn to cope with, and it is hard to find a balance between protecting them, and preparing them. I did not feel that Toxic Childhood made many positive suggestions about embracing change.

05 Sep

Book Review: My Child Won’t Eat, by Carlos Gonzalez

After enjoying Gonzalez’ Kiss Me! so much, and with a long standing interest in the subject of solid food, I looked forward to reading My Child Won’t Eat, and hoped it would have some useful information that I could pass on in my Introducing Solids Workshops.

The book is sensibly divided into Causes, Solutions, and Prevention, and uses a rich selection of anecdotes to illustrate the points made in each section.

Gonzalez’ basic premise is that babies and children can be allowed and trusted to regulate their own appetites; and that it is the parents’ expectations that are wrong. If parents stop worrying about it or trying to force their children to eat, they will still eat the same amount, but it will all be much less stressful. They won’t eat any more than they did before, but they won’t waste away either.

This premise is entirely sensible and based in the science relating to appetite control, and Gonzalez uses the perspective of the child to argue that mealtime battles are confusing and unhelpful when it comes to creating a positive attitude to food.

The book includes a large section on breastfeeding, which, as the author acknowledges, is likely to come too late for the parents of babies or toddlers eating (or not eating) solid food, at whom the book is targeted. Perhaps this would be more useful for health professionals and other people supporting those parents.

I found some of Gonzalez’ recommendations to be highly directive and some of his language is really quite judgemental. On the subject of introducing potential allergens, he writes:

Before one year, introducing many different foods only means buying more tickets for the allergy lottery.
p.118

which is sweepingly dismissive, and not in line with current recommendations from the Scientific Advisory Committee on Nutrition, whose review of the evidence concludes that there is currently no clear indication that early (or late) introduction of certain foods either prevents or triggers allergies.

I am not sure I learned anything new from My Child Won’t Eat, but the book gave me plenty to reflect on, and has helped to develop new perspectives and different ways of explaining things to parents.

*****

To order My Child Won’t Eat! with a 25% discount, just follow the link and use the discount code KH25 at the checkout.

12 Jul

Book Review AND GIVEAWAY: Kiss Me! by Carlos Gonzalez

Subtitle: How to raise your children with love

Dr Carlos González sets out his stall very clearly in the first pages of his book:

This book assumes all children are essentially good, that their emotional needs are important, and that we as parents owe them love, respect and attention [p13]

He demonstrates this last point over and over again, by taking the statements of various childcare experts and graphically substituting the word ‘child’ with ‘wife’ or ‘colleague’ or ‘prisoner,’ revealing shocking double standards in our expectations and our treatment of children.

The book is roughly divided into two main chapters, the first of which presents children’s behaviour in terms of survival, adaptation, and genetic predisposition. González reframes disobedience as instinct, explaining for example a toddler’s preference to be carried rather than walk as a deep instinctive drive for safety and security.

The other half of the book is given over to demolishing various parenting theories including sleep training, therapeutic crying, and smacking. It is particularly gratifying to read his meticulous critique of Dr Christopher Green, that unpleasant advocate of smacking, whose basic assumption is that children are all ungrateful tyrants in need of taming.

González’ style is ranty in the extreme, and occasionally it is hard to tell if he is being sarcastic. This book gave me a lot to reflect on with regard to the way I talk to new parents and try to help them understand their babies’ behaviour. But however much I enjoyed this most arid humour, and however valid his premise and instructive his examples, I am wondering whether I would recommend Kiss Me! to new or expectant parents.

González writes with great empathy for children, but much less for parents; who, he explains, are inevitably confused by woolly and non-evidence based ‘advice’ from authoritative experts. His suggestion to combat this is that all parenting books should state on the cover what the author’s basic philosophy of human nature is.

Kiss Me! is an interesting book, and its most useful chapter focuses the mind on understanding, respecting, and empathising with children. Despite his strident tones, this is a very healthy approach to parenting.

***
I’ve got a copy of the book to give away to a commenter. I’ll draw names out of a hat on Thursday 19th July, and the book will be sent to you.

To order Kiss Me! with a 25% discount, just follow the link and use the discount code KH25 at the checkout.

15 Mar

Book Review: Birth Matters, by Ina May Gaskin

Ina May’s new book is a manifesta setting out the philosophy of natural birth, and therefore nothing that has not been said by wise women (and men) countless times before. The value of this work is its comprehensive, detailed, and clear presentation of the information, such that surely no rational human could disagree. It is The Politics of Breastfeeding for birth, and it is a scientific celebration of what nature has achieved and what women are capable of.

The first chapters set the subject in its global context, and birth stories are scattered through the text to remind the reader that while these are global, political issues, they have personal, individual impacts.

I have learned about the cultural loss of breastfeeding knowledge, and it makes a sad kind of sense to me to be reading the same description of society’s attitude to birth: the loss of skills among health professionals and the consequent loss of positive birth stories. This cycle will be perpetuated and added to, and will spread beyond the US increasingly rapidly, as we lose touch with and confidence in our own bodies.

Ina May Gaskin discusses the role of feminism in driving an ‘escape’ from pregnancy and motherhood, a push towards equality between men and women instead of a celebration of the important differences between us. Why should power be measured only in masculine terms and defined by the choice NOT to do something? Ina May’s positive, empowering feminism offers a far wider range of choices.

It seemed crazy to me to take on the belief that the human female is the only mammal on earth that is a mistake of nature… it’s our minds that sometimes complicate matters for us. (p.23)

She quotes Simone de Beauvoir describing the pregnant women as inciting fear in children and contempt in young people, ensnared: “life’s passive instrument.” De Beauvoir, the great feminist intellectual, writes as though she believes what men have said for centuries about women’s bodies: that we are disgusting, inefficient, and inferior to men (who cannot, normally, grow or feed babies); and seems unaware that historically speaking, medical men who profit from managing birth have had personal and financial interests in telling women that it is a dangerous and painful process, that requires the presence of a qualified doctor. Again the parallels with the unethical practices of formula manufacturers undermining women’s knowledge of and confidence in breastfeeding are clear.

Some of the practices resulting from this basic assumption of women’s inferiority and ignorance are barbaric, and many persist in 21st Century western healthcare. The book describes a bleak outlook for maternity care and motherhood in a world where politics and economics are everything. Yet the short-termism of the idea that labouring women must be cured or rescued from themselves costs far more in terms of money, life, and quality of life. How can this be an acceptable situation?

I was struck by the anecdote in which a couple kissed to raise oxytocin levels and aid relaxation and the progress of labour. It helped me to think about the way I talk to antenatal groups about the role of oxytocin in breastfeeding. And also of the way the idea of sex to bring on labour has been reduced to the role of prostaglandin, when everything about it promotes skin contact, eye contact, and a feeling of well-being. In this, I find yet another example of the big picture being reduced to one male-orientated detail.

I was aware that birth in the US was highly medicalised, but the details and the implications of that, as clearly laid out by Ina May Gaskin, are horrifying and depressing. At the same time, the positive birth stories are affirming, empowering tales, a contrasting picture of the good that is possible when women are informed and respected.

***

To order Birth Matters with a 25% discount, just follow the link and use the discount code KH25 at the checkout.

08 Feb

Book Review: The Oxytocin Factor, by Kerstin Uvnas Moberg

On the whole, this is an interesting book exploring the magic of the hormone oxytocin, its widely varied effects, and the gaps in our knowledge about it.

The author describes the ‘calm and connection’ system, and contrasts this with the ‘fight or flight’ system, which has already been widely researched. She posits that modern life gives little opportunity for human beings to enjoy the various conditions of rest, relaxation, and pleasant interactions, which cause a natural increase in levels of oxytocin.

The book is divided into parts, and begins with an explanation of the physiological processes involved in the calm and connection system. All this makes a lot of sense, although much of it is based on research with rats.

The section on the effects of oxytocin is the most interesting part of the book. It shows that oxytocin increases sociability, curiosity and nurturing behaviour, and decreases anxiety and fear. It enhances recognition and calm, and alleviates pain. It improves the ability to learn; and, in different circumstances, either raises or lowers blood pressure. It moderates body temperature and enables a mother to moderate her baby’s body temperature. It regulates appetite and makes digestion more effective. It aids growth and healing, and the flow of breastmilk, and the contractions to birth our babies. All of these different effects have the result of enabling animals to grow and to reproduce.

The chapter on breastfeeding is fascinating. However I noticed here and elsewhere some remarks that I know are not supported by evidence, including that mothers who have had a c/section have more difficulties in breastfeeding, the assumption that colic is a stomach disorder, and the assertion that breastfeeding women must avoid alcohol. This leads me to wonder how much of the rest of the content of the book is actually based on real evidence of human experience and behaviour.

Certainly the final section of the book is almost entirely based on speculation about the gaps in our knowledge, and uncritically discusses the role of oxytocin in acupunture and other complementary medicine.

I found much that was useful in this book, particularly on the subject of bonding, and specifically in relation to fathers, which is very relevant for me in my work. However I found the speculation in the final chapters vague and disconnected. I was surprised, given the original assertion that modern life is not conducive to natural oxytocin release, to read that the author is looking forward to oxytocin being available as an drug that can be administered for various conditions. I had expected the book to conclude that human beings need to use our knowledge of natural oxytocin to engage in more behaviour, or create more circumstances, where oxytocin is naturally maximised; not just to pop a pill to achieve all those beneficial effects.

***

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

25 Jan

Book review: Successful Infant Feeding, by Heather Welford

This comprehensive book takes a broad view of infant feeding, including how-to sections for both breast and bottlefeeding, along with an interesting examination of the history and politics, and the social and emotional aspects of the subject. It gives enough detail to be useful to breastfeeding supporters and other health professionals, without being too dense for parents and parents-to-be.

I warmed to the book immediately on reading the opening chapter, about babies’ development over the first year. This sets the subject of feeding nicely into the wider context of babies’ needs; and yet, without pulling any punches about the risks of formula feeding, manages to be inclusive and non-judgmental about the range of choices that parents make. Importantly, Welford acknowledges that, for many parents, formula feeding is not a choice willingly or happily made, and that it is very hard for health professionals to get the right tone when it comes to supporting parents in making decisions about feeding.

This book is useful because as well as accurate how-to information, it also touches on a range of special situations and common concerns, briefly explains the WHO code, and looks at how individual babies’ feeding patterns might change over time. It even includes enough information on the introduction of solid food to render the purchase of anything by Annabel Karmel completely unnecessary.

The language used is crystal-clear and helpfully free of value-laden terms. I have already heard myself reciting bits of it in antenatal classes (while hoping that Heather won’t want any royalties!), have sent a copy to my sister-in-law who is expecting her first baby, and recommended it widely. It is the book that our profession has been waiting for, and should be on the reading list for anyone working with new parents.

10 Jan

Book review: You, Me and the Breast

This is a colourfully illustrated book about breastfeeding. Its simple story follows a mum and baby from birth to weaning, and mentions lots of memorable moments, such as snuggling up in bed with daddy, mama milk to comfort and soothe, and those relaxing moments where one’s ever-active infant becomes still for a little while at the breast.

Although it is clearly presented as a children’s book, I was a little confused about who the target audience was. Some of the information: ‘my nipple darkened… and gave off a rich smell’ sounds unnecessarily technical in a book for a small child. The cursive script was too difficult for my competent five year-old to read himself, and he had a lot of questions about the illustrations (‘which one is her hand?’ ‘why has she got birds in her hair?’).

It was nice to see dad included in some of the pictures, although I have reservations about the depiction of him ‘aeroplaning’ puréed food into the baby’s mouth.

On balance, the more books for children that normalise breastfeeding, the better. It would be good to see this widely available in local libraries and schools.

***

To order You, Me and The Breast with a 25% discount, just follow the link and use the discount code KH25 at the checkout.