21 Oct

Book review: Milk, by Emma Rosen

Emma Rosen knew she had a book in her, and motherhood gave her the material. Milk is, as subtitled, a story of breastfeeding in a society that’s forgotten how. The thing that will stay with me long after reading this, is how strongly I identified with her experience of feeding her first baby; and (although I never experienced this, having stopped at one), how healing I found it to read about her second birth, along with the feeding and mothering experience that I will always wonder if I could have had. I hope this book gets out to pregnant women, in that place where it is hard to grasp the reality of life with a baby, and prepares them just a little bit more to navigate those early months.

Emma’s book alternates between telling her own story, and telling the story of breastfeeding; and in doing so, places her own experience within the wider context of breastfeeding in 21st Century Britain, and in the world, and all of history. There is so much useful information here, and it is thoroughly referenced, too.

For anyone looking for insights into pregnancy, birth, and the world of a new mother, this is a really lovely read, and one that doesn’t shy away form the gritty reality of the physical and emotional changes of this momentous time. This might be the first time I’ve read a book that really succeeds in conveying that reality without either hyperbole or sugar coating. A properly good book.

[Disclaimer: I was sent a preview copy by the author. You can buy it from all the usual places.]

27 Aug

Book review: New Walk, by Ellie Durant

New Walk is the first novel of midwife Ellie Durant, and a fitting companion-piece to Alice Allan’s Open My Eyes from the same publisher. It tells the story of Chloe, a Leicester teenager who has been the responsible member of her family in the years since her mother died, and has finally decided to do something for herself, and applies to study midwifery.

The main philosophical theme of the book is that dilemma between selfishness and responsibility: do women have the right to decline medical advice? Or to choose what happens to their own bodies? And who has the power?

Chloe is a likeable character going through some tough times, supported (or not) by a diverse cast. The plot may not twist much, but it is soundly structured, satisfyingly ended, and well decorated with the details of Chloe’s learning about pregnancy and birth. Ellie Durant writes confidently about what she knows, giving this novel a sincere and grounded feel. It’s light reading with some darker tones: great summer lit.

[Disclaimer: I was sent a free copy of New Walk by the publishers Pinter & Martin. Get yours here with a 10% discount at the checkout, using the code SPROGCAST]

03 Jun

Book Review: Inducing Labour: Making Informed Decisions, by Dr Sara Wickham

Sara Wickham’s new book Inducing Labour: Making Informed Decisions aims to explain the process of induction to parents and to professionals. It very clearly covers the how and why, and comprehensively goes into the risks and benefits of the most commonly encountered scenarios. Wickham argues strongly for women’s bodily autonomy and individualised care, and the whole book is set firmly within the evidence base. Her discussion of the evidence was for me (and unsurprisingly!) the strongest point of an all-round excellent book, and I was prompted to reflect on her point that we all interpret the evidence according to our existing biases.

This is a book written for women, addressing “you” the pregnant mother, but without holding back any technical points or difficult statistics. It is also an important read for antenatal teachers, midwives, and anyone supporting women to make decisions about their care. There are, for example, some useful points that a woman can use for agreeing a “due date” with her midwife or consultant, and some questions that are helpful to ask in order to ensure care is personalised rather than simply following a protocol. Above all, there is really clear information about the impact of induction in a number of different situations, and a good breakdown of statistics for example on the risk of stillbirth in older mothers, and how likely it is that earlier induction would make much difference to these stats (answer: not very likely).

In fact the message that comes across most clearly is to trust women and to trust women’s bodies. The evidence that induction routinely improves outcomes is simply not there, and anyone needing to argue that point with a clinician would find this book a really useful resource. In a culture where the baby’s safety is prioritised over everything, it is good to read a practical, straightforward discussion of why intervention is often not the best way to do no harm.

I was sent a free review copy of Inducing Labour. You can get more information here, and your own copy from here.

20 Apr

Book Review: Your No-Guilt Pregnancy Plan, by Rebecca Schiller

I’ve been waiting for this book for years – since my own pregnancy, in fact.

Rebecca Schiller, director of Birthrights, has created a manual for pregnancy, birth and the early weeks of parenthood, that is mother-centred and evidence-based, and achieves that incredibly difficult feat of getting the right tone when balancing those two things.

Your No-Guilt Pregnancy Plan – A revolutionary guide to pregnancy, birth and the weeks that follow skips the “your baby is the size of a walnut/pear/skateboard” theme that most writers on this subject consider to be mandatory, and focuses on what is happening to the woman: how she might be feeling, how her body is changing, how the pregnancy/baby affects her world. It includes exercises and checklists to help women reflect on their goals and enjoy the experience; and is kept completely up to date with an accompanying set of links to further reading and support on Rebecca’s own website.

As with most such books, there is a chronological approach. However some things you will not find in most such books are a clear emphasis on the rights of women, on the basis that when women are well cared-for and respected, outcomes improve for them and for their babies. It’s a very realistic book, and a fine example of giving information without advice. With one or two small exceptions, this book is about the reader, not the writer.

And so we come to the breastfeeding section, which you know I looked at first. It’s good. It covers the basics of milk supply and positioning, some of the early challenges, and where to go for help. This sits alongside clear guidance about formula feeding, and not a lactation cookie in sight.

The final chapter of the book helps the reader to refer back to relevant sections of the book, in order to create a personalised plan for pregnancy, birth and afterwards, including a going into labour checklist, and a ‘little black book’ of support for the early days, so you don’t have to figure it out when you need it.

This is the most realistic, practical and informal guide I have seen, and goes straight to the top of my pile of recommendations.

[Disclosure: I received a free review copy of Rebecca’s book.]

08 Jan

Prepare for the worst

This week I’m hearing a lot from the 3rd Annual Birth Trauma Conference, particularly about mental health after birth, and how well prepared – or not – women feel. Milli Hill pointed out in a tweet what a straw man it is to blame antenatal preparation alone:

“Blame goes to antenatal teacher, or the woman herself…but oddly never to the system that doesn’t give women optimal chance of straightforward birth but instead often traumatises her. #birthtrauma18”

There are two things to look at here. One is how possible it really is to cover birth trauma and an issue as serious as postnatal psychosis, in a group of 8 couples (for your average NCT class), in a limited period of time and alongside other huge important topics, and in a context that is intended to empower women in the birthplace? The other is, how much impact does antenatal education have in the face of the barriers to straightforward birth including but not limited to lack of continuity of care, time pressures put on women by staff with time and protocol pressures on them, lack of real informed consent, and a society-wide assumption that birth is difficult and dangerous, and a healthy baby is all that matters? It’s a lot easier to say “NCT set me up to fail” than to acknowledge that the entire system sets women up to fail.

I spend much of my working hours and my voluntary time chipping away at the system, and write and broadcast constantly about those big issues. So let’s just look at that one smaller issue, how we tell a group of already-fearful pregnant women that birth might leave them with PTSD, without undoing all the work of empowering them to trust their bodies and birth their babies with as little unwanted intervention as possible. I can’t speak for all antenatal education (and let’s not forget that NCT isn’t the only provider of antenatal courses), but I can tell you about my own. I do this in small groups, providing a set of handouts and a case study for each group. The case studies cover baby blues, postnatal depression (men and women) and relationships and expectations after the birth. The handouts also mention postpartum psychosis. The ensuing discussion covers risk factors, symptoms, self-care, support, and so on. Some groups really engage with this, and often when someone has experience of depression, they make very valuable contributions. I’m always aware that there may be people who have experienced it and will stay very quiet. Once I observed an antenatal session where the practitioner covered feelings after birth immediately after doing a relaxation, and left the lights down low; in that atmosphere of safety and calm, a woman shared the story of her antenatal depression and it was powerful.

I just want to say that if even NCT, who have the best trained and most rigorously assessed antenatal practitioners out there, can’t always get this right for women, perhaps we need to go back and take on the difficult task of addressing the big issues, and work together instead of blaming – which potentially puts people off accessing valuable support and education. It’s also worth noting that antenatal educators of any brand don’t operate in a cheerful idealistic vacuum: we sit on Maternity Voices Partnerships, we campaign, we listen to women, we make and listen to podcasts, we are mothers; and we are involved in the system and we are active in trying to make it better. “Setting women up to fail” is an unfair accusation.

31 Dec

A trilogy of book reviews

These are the last three books I have read in 2017, a very satisfying year when it comes to reading. I am not sure how I have managed to find the time, but hope that a less crazy 2018 might mean even more reading time!

A Midwife’s Story – Penny Armstrong & Sheryl Feldman

In this memoir of midwifery among the Amish community, Penny Armstrong reflects on her growth and development as a midwife. It’s fascinating to see her confidence in straightforward birth in a home environment increase through experience. She is well-placed to make the comparison with hospital birth in the 1970s, and it is horrifying to note how little has changed. The vignettes of Amish life are also charming, and this is a well-written memoir – certainly the best story of midwifery I’ve read, thanks to writer Sheryl Feldman’s well-judged turn of phrase. I found it utterly absorbing.

[Disclosure: Pinter & Martin sent me a free review copy of this book; you can get a 10% discount on your copy if you use the offer code SPROGCAST at checkout on their website.]

How To Have A Baby – Natalie Meddings

How To Have A Baby is a doula in a book. It’s nearly a big enough book to fit in an actual doula, and crammed with wisdom (just the “big necessaries,” writes Natalie Meddings) sourced from her own experience and the stories of many mothers. Meddings’ tone, like the ideal doula, is firm but gentle, calm and encouraging.

The book takes the expectant mother through the usual route of pregnancy and planning, into labour, birth and the unexpected, and out the other side to feeding and newborn days. Descriptions are clear and “tips and tricks” are shared helpfully at every stage. Meddings is pragmatic and honest. Birth is discussed in terms of an involuntary bodily function, and how to create the optimal conditions for this to happen. Induction is presented as “a ticket on the intervention rollercoaster” (p116) which is an interesting choice of words, however the pages explaining induction are practical and compassionate, giving a clear idea of what happens and what can help.

This book is an excellent resource for birth planning. Meddings is very concerned with consent and human rights, both of which she covers very clearly; and this is her real strength. I much prefer these well-referenced and forthright pages, to the liberal sprinkling of homeopathy etc alongside the useful coping suggestions.

You are waiting to hear what I think of the breastfeeding information, so I won’t keep you in any more suspense. With contributions from Maddie McMahon, the importance of early feeding and skin to skin is discussed, and Meddings describes the newborn feeding reflexes and how to support the baby to self-attach. It is a little surprising when she goes on to describe a rather prescriptive way to hold the baby, which does not support those reflexes so well, given her let-nature-take-its-course-and-things-will-work approach to other aspects of birth and parenting. And sound the klaxon for “breastfeeding granola,” which looks delicious but should correctly be termed “granola,” given that breastfeeding experience is not generally influenced by the consumption of roasted oats and nuts and so on.

Matters are redeemed by the rest of the new-baby/new-mother section, referencing such respected authors as Naomi Stadlen and Deborah Jackson, and with plenty of exhortations to eat cake.

I think this book is jam-packed with stuff that would be useful during labour and birth, and it would set up a new mother nicely for those early days and beyond. Practically speaking, the book is probably a bit too chunky to carry around with you and make notes in, as Meddings suggests in the beginning; in fact I think it would work brilliantly as a loose-leaf binder (or perhaps an app), so the reader can pull out relevant sections as needed (which would facilitate reading whilst feeding). Some websites and numbers are given to access support but there could be a lot more of this. On the whole a very highly recommended book for practitioners and parents-to-be alike.

[Disclosure: Natalie sent me a free copy of her book to review – thank you!]

Eleven Hours – Pamela Erens

The last book I finished reading this year was perfect to follow these two, and I think I may even have bought it myself. In Eleven Hours, Lore is in labour, cared for by Franckline who is also in the early stages of pregnancy. As Lore’s contractions come and go, we learn both women’s sad stories: Franckline’s lost babies, and Lore’s lost love. Franckline’s midwifery is full of empathy and kindness, but this is starkly framed by the harsh restrictions and requirements of hospital policy, and the insensitive words and actions of her colleagues.

Lore arrives in the maternity ward alone, with a five page birth plan. Franckline is the only one to read and respect this, and does her best to steer things back towards Lore’s wishes, even as events keep on sliding off track. The labour progresses slowly, and then takes an unpredictable turn. Gripping fiction, and a great way to wrap up Meddings and Armstrong, and 2017.

12 Dec

Book Review: The Expectant Dad’s Handbook, by Dean Beaumont

This book came out a few years ago to accompany Dean Beaumont’s DaddyNatal antenatal course for men. It covers pregnancy, labour and birth, and life after birth, in a chatty but intelligent style, while keeping the focus firmly on the partner’s role in supporting the new mother or mother-to-be. I like Beaumont’s approach of describing the situation and the options available, and then exploring what the partner can do to give support.

As with all such books, the first chapter I looked at was the one on breastfeeding. Unlike the birth chapters, Beaumont gives no ‘how it works’ information, which is disappointing given that I often find the men in an antenatal session to be fascinated by the science. In a scant five pages, there is a little too much focus on how dads can get it wrong, and of course the inevitable suggestion that they can help out by giving a bottle, with little exploration of the complications that this can introduce. Formula feeding doesn’t get so much as a sidelong glance.

However, this is the weakest part of the book, and in fact the information on labour and on life with a new baby is thorough and evidence-based. I would recommend this book to an Expectant Dad, but I’d also suggest something a bit more comprehensive on feeding, alongside.

23 Nov

Book Review: Beautiful Birth, by Suzanne Yates

This is a nice book, a keeper for sure. Beautiful Birth is an attractive, slim volume with an immediate appeal to anyone looking for practical techniques for coping with childbirth.

It has two main sections. The first section covers breathing and visualisation, positions for labour, and massage. It gives an uncomplicated rationale for why these things are helpful, and a step by step approach to practicing them during pregnancy, and using them during labour. It does include a little more chinese medicine and shiatsu than I would normally be comfortable with, but actually the book is so useful that for once I’m not going to make snarky comments about that.

The second section is on preparing for birth, and is a straightforward explanation of what happens and how a woman can use the coping techniques from the first section, to help herself have a positive experience. Its approach to planning the birth is about connecting with yourself and reflecting on what kind of environment and support feels best. It touches on decision making when things don’t go to plan, and very briefly on the “fourth stage” of labour, meeting the baby.

I think most pregnant women could find something useful in Beautiful Birth, whatever kind of birth they are expecting; it’s never unhelpful to have some strategies for bringing calm. It’s a shame the pictures are not more ethnically diverse, but I would generally recommend this book.

[Disclosure: I was sent a free review copy by the publishers. You can get hold of it here, with a 10% discount at the checkout using the code SPROGCAST]

16 Nov

Book Review: Trust Your Body Trust Your Baby, by Rosie Newman

Rosie Newman’s book aims to inspire confidence and trust in a mother’s own instincts, through pregnancy and birth, feeding and mothering. It is a book for women who need help with the paradigm shift of becoming a new parent. One of the things that really comes across is the value of surrounding oneself with like-minded, positive people. Newman is well-read and draws extensively on the literature of attachment parenting and straightforward birth.

Trust Your Body Trust Your Baby is sensibly structured with a logical progression, starting with a practical chapter on preparation for the baby’s arrival. The birth chapter gives an interesting history of obstetrics, an explanation of the role of hormones, and a valiant attempt to convey the reality of labour.

The following chapters cover life after birth: establishing breastfeeding, sleep, attachment, and the emotional and psychological adjustment. All of this is extremely good stuff that I would recommend to new parents; it is well-referenced and although it comes from a firm base in attachment parenting, and includes a great deal of Newman’s own experience, it is written with empathy and compassion for both the mother and the baby.

The last chapter is on elimination communication, and might make some new parents wonder if this really is the book for them, or whether it is too far from the mainstream. My clients tend to think The Baby Whisperer is a “a bit of a hippie,” so I’m conscious of wanting books like this to be accessible. Of course there is a huge part of me that really doesn’t want to pull any punches, too.

I was writing this review at a very quiet breastfeeding drop-in. Two mothers came in and we were talking about the conflict between trusting your instincts as a mother, and coping with the pressures of modern life, lack of sleep, lack of support, and the weight of expectations that babies should behave in a certain way by a certain age (both babies were 3 months old and not behaving in a certain way at all). So I gave one of them the book; may it help her find her way.

[Disclosure: I received a free review copy of this book from the publishers. You can get your own copy here, and a 10% discount using the code SPROGCAST at the checkout].

29 Aug

Book Review: Growing Up Pregnant, by Deirdre Curley

I sat up in bed and admired all the women in the room. All of us had different birth stories, and we each realised how lucky we were to have healthy babies. Although we were all at different stages in our lives, we were all going to be going through the exact same transition into motherhood. (p184)

Deirdre Curley is pregnant and 19. She is surrounded by a supportive family and a loving partner. She really wants to be an actress, and she isn’t at all sure she wants to be a mum.

In Growing Up Pregnant, she tells the story, not just of pregnancy and birth, but all the things that bring her to this point. And then in detail she takes us through the months of her pregnancy, and the reader witnesses her maturing from good-time girl to “the most beautiful pregnant lady” one waitress has ever seen. When she and her partner make up their minds that they will be parents, they commit to the changes they need to make, even when it’s hard to adjust to the loss of old pleasures and still-partying friends. It’s so interesting to read about their mixed feelings as they adjust to this new lifestyle, and the strength and positivity they bring to it is admirable.

Deirdre pauses between each trimester to give a little rundown of what a pregnant woman might be experiencing, how her baby is developing, and any preparation she might consider doing. This includes the most down-to-earth “what to buy” lists of any pregnancy book I have read. She refrains from too much specific detail about pregnancy and birth, but gives a useful overview that would be relevant to a pregnant woman of any age.

This is a properly grounded book, both reflective and informative, and does as good a job as any (and better than most) of getting across what it’s really like to be pregnant and to have a baby. Although the focus is on pregnancy as a young mum, most of the feelings Deirdre expresses are pretty universal: what is happening to me? Will my body ever be the same again? Can I rely on the support of my partner? Am I going to be a good enough mum? Women twice her age think the same things.

I enjoyed taking this journey with Deirdre and her partner Gary, as they put down roots and prepare for the baby. The birth itself is well-written, and early motherhood is covered with both wistfulness and joy. It is a very realistic description and I would certainly recommend this book to pregnant women, whatever their age.

[Disclaimer: I was sent a free review copy of Growing Up Pregnant. You can order yours from Pinter & Martin, with a 10% discount at the checkout if you use the code SPROGCAST]