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.]

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.

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]

21 Jun

Book review: The Importance of Dads and Grandmas to the Breastfeeding Mother, by Wendy Jones

I would consider Dr Wendy Jones to be one of the most trustworthy resources on breastfeeding in the UK, particularly in her specialist area of breastfeeding and medication. This is a general book about breastfeeding, aimed at fathers and grandmothers. The dad-focus is on how to help (and a little bit of how not to) given that fathers may not fully appreciate the importance of their role to start with; and the granny-focus is on reframing some of the older generation’s expectations and preconceptions, given that they may have done things differently themselves.

Jones lays out the rationale for her advice, with a detailed explanation of what breastmilk is and how breastfeeding works. Each chapter includes a summary of take home messages, and she covers many “But what if…?” scenarios. Well-referenced, with a decent index and a list of helplines, this could be a very useful book. It’s worth pointing out that it covers formula feeding, sterilising equipment, and expressing in some detail too.

My small criticisms would be that the pictures are often small and unhelpful (although there are many good diagrams and tables of information), and being in black and white they are not at all useful for illustrating the colours of newborn poo or changes to a nipple after feeding. I disagree with Jones’ description of colic as pain/wind, when so many authoritative sources, including the NHS, define it as unexplained crying. Perhaps it is difficult to take the pharmacist hat off altogether.

Where Jones does take the pharmacist hat off, however, is in her friendly personal tone, and in the “bonus feature” of her own story about supporting her daughters with breastfeeding, which is fascinating and moving.

This is a book I will keep to hand as a good source of reliable information, and I would widely recommend it to breastfeeding supporters, and of course to Dads and Grandmas.

[Disclaimer: Wendy sent me a free review copy of her book – thank you! We had a chat with her on Sprogcast a little while ago; listen here]

20 Jun

Book Review: Why Starting Solids Matters, by Amy Brown

The subject of starting solids divides parents into those who trust their instincts and those who do not. Those who trust their instincts will enjoy this book, which offers evidence to help them make decisions; but they won’t need it. Those who do not, will find it insufficiently instructional. This is the eternal dilemma of the subject, and Amy Brown recognises that.

This is not a manual for introducing solids. It’s a really good resource, though, for anyone supporting parents in either state of mind. It is a sensible, well-researched little book, casting no moral judgement on any of the different options, even as it sets out the compelling arguments for waiting until around 6 months, and enabling babies to self-feed.

Why Starting Solids Matters gives us an interesting history of infant feeding, which lays foundations for the following chapters. It acknowledges the sparsity of good evidence around allergies, and really makes its point about the importance, above all else, of responsive feeding.

Closing with a ten-step summary and a long list of resources, and thoroughly referenced, Why Starting Solids Matters ticks all my boxes for a thoroughly useful book. I fervently hope that it will be as widely read as it deserves.

[Disclaimer: The publishers sent me a free review copy. You can buy it from their website, and get 10% discount with the code SPROGCAST]

09 Jun

Book Review: The Happy Birth Book, by Beverley Turner with Pam Wild

Beverley Turner’s Happy Birth Book was originally conceived as a handbook for people attending her high-end antenatal courses, and covers a huge range of topics in alphabetical order, so that readers may dip in or look up the thing they’re interested in. Hitting the same market at the same time as Clemmie Hooper (and with a matching cover image) and Milli Hill, Turner’s book lands somewhere between the two, closer in tone to Hooper, but in content to Hill. All three focus on active birth, but while Clemmie digresses into shopping lists, Milli and Bev are both encouraging women to get informed and assert their rights in the birthplace.

The Happy Birth Book is good for instructive diagrams, pithy descriptions (she’s especially good on labour), and a few moments of truly gritty realism which made me laugh out loud. There is a lot of ‘Bev’ and therefore a lot of opinion, and rather too much alternative therapy for my personal taste. I wasn’t too impressed by the breastfeeding information, which tends to give the impression that babies can be fed on a regular timetable, that mothers should eat well to maintain a good milk supply, and that breasts need time to fill up between feeds, none of which is scientifically accurate.

The A-Z approach doesn’t feel to me like the most intuitive way to organise the subject matter, and certainly going from skincare to stillbirth to stretch marks is a bit of a bumpy ride. On the other hand, it does make it – as intended – a book you can dip in and out of, and have to hand for extra information as needed. With its cheery, direct tone, it’s a good alternative for readers who might find the more comprehensive Positive Birth Book a bit too dense, and definitely more empowering than most of the mainstream birth books out there.

[Disclaimer: I was sent a free review copy by the author, and also had a lovely chat with her for the July episode of Sprogcast]

06 Jun

Book Review: Breastfeeding Made Easy, by Carlos Gonzales

Carlos Gonzales writes as though he is giving a TED talk. In places, his stridency is amusing; but mostly it is just strident. I cannot tell if it would come across the same way in the original Spanish, or if this is a tonal quirk of the translation, but I did experience the same sense of being exhorted to follow his well-argued directions in his earlier books, and for this reason I would be very unlikely to share them with parents.

Breastfeeding Made Easy is a dense book filled with much confusing detail, and is quite outdated. For example, on p53 he discusses “foremilk and hindmilk,” a concept from which most breastfeeding authorities have moved on. Gonzales is, furthermore, highly prescriptive in his approach to positioning and attachment, and there is no mention at all of laid-back breastfeeding. He makes several sweeping statements that many parents would rightly disagree with. Here’s one:

breastfeeding stops being an issue when the baby starts eating solids (p84)

To which I say: hm, define “issue.”

The book also swings from exhaustively detailed advice such as that given on maternal diet (which in fact has very little impact on milk quantity or composition), to peculiar inclusions in the list of maternal conditions that may affect breastfeeding such as myopia – which, obviously, doesn’t affect it at all.

There are far more useful breastfeeding books available; this one is little more than an eyebrow-raising curiosity.

[Disclaimer: I was given a free copy of this book by the publishers Pinter & Martin]

05 Jun

Book Review: The Sensational Baby Sleep Plan – Alison Scott-Wright

I have come across this book a few times, and eventually someone gave me a copy so that I could read it cover to cover at my leisure. Having flicked first to the breastfeeding section and read the advice not to drink champagne lest it give the baby wind, I was tempted to drop it straight in the bin. But no, I persisted, so that you don’t ever have to.

Alison Scott-Wright is very much from the same school as Clare Byam-Cook, whose awful book she recommends; and really you don’t need to know much more than that. If you consider your baby to be a time-consuming, manipulative bore with no feelings, the Plan will suit you just fine. However if you wish to meet your tiny human’s needs following your parental instincts and the best available evidence, and your well-meaning aunt has given you a copy of this book, perhaps treat it as a “how not to parent a baby” guide.

Feel free, in the latter case, to ignore ASW’s basic premise that breastfeeding is really too difficult to bother with; a position that must be continually supported with anecdata from clients having trouble getting breastfeeding to work under the rules she prescribes. Feel free not to ensure your legs are at a 90 degree angle to your body (p41), not to restrict feeds to 3-hourly as soon as possible (p43), not to express five times in 24 hours in addition to breastfeeding on demand (p46), and take with a huge pinch of salt that breastmilk may be made unnatural and impure by environmental pollution. Amuse yourself instead with the mental image of cows living in clinical conditions, wearing nappies and using the finest organic antibacterial gel on their udders at milking time. Should you decide to use formula, please please disregard her instructions for making up bottles in advance, which is in direct opposition to evidence-based guidance from the NHS.

None of her terrible advice about feeding has very much to do with sleep, so let us move on to ignoring what she says about that. ASW likes to cherry-pick the research and twist it to fit her entrenched opinions. So for example she quotes Sue Gerhardt on early emotional development and uses this to argue in favour of her cruel and neglectful plan. If she had read more than the back cover of Why Love Matters, she would find herself in the uncomfortable position of having to reflect on how damaging her advice must be.

ASW does not, however, make any reference at all to the UK’s foremost authority on infant sleep, the work of Professor Helen Ball and Doctor Charlotte Russell at the Durham Infant Sleep Lab, where they undertake rigorous research and provide useful evidence-based information to support parents. And for this reason, the reader may also be at liberty to ignore the “baby’s daily sleep requirements” (p72), fully debunked by Charlotte Russell on Sprogcast last year. On p80, ASW dangerously disagrees with current safe sleeping guidelines, overruling the Back To Sleep campaign on the basis that she tends to believe that the babies for whom her plan does not work must surely have reflux; and also ignoring the increased risk of SIDS for a baby sleeping in their own room before the age of six months. It would also be absolutely acceptable to take no notice whatsoever of her claim that she “often advises introducing solids… from 16 weeks,” (p85) or her recommendation that parents water down formula or limit breastfeeds at night as early as 4 weeks, thereby depriving the baby of essential nutrients and comfort – surely a far more serious risk to the child’s physical and emotional wellbeing than that posed by sleep deprivation.

All parents can definitely disregard the long parent-blaming list of ways they can get their babies’ sleep wrong on p155; and unless the baby has a medical diagnosis of reflux, they can also take no notice of the 50 pages devoted to that subject. In fact, even with such a diagnosis, it might be wise to ignore the unqualified ASW’s unqualified opinions on this matter, and seek the support of a trained specialist.

ASW’s promise is that if you follow her “flexible” plan TO THE LETTER, then your baby will sleep through the night by 8 weeks. She has had 100% success with this. The only reasons why this incredible plan might not work are if the baby has reflux, or if the parents have been doing it wrong. Even teething “should not be used as an excuse” (p92). But never fear, silly parents, if you have got yourself into such a “hopeless situation” (p157), there is still hope! You can adopt her cosily-named “sleepy time” reassurance technique (p170) which is basically leaving the baby to cry, even if they “vomit to order” (p193).

This sleep is indeed sensational: sensationally cruel, ill-informed, and quite possibly harmful. I do not recommend this book.

21 Mar

Book Review: The Positive Birth Book, by Milli Hill

This is an interesting and extremely thorough manual for birth, written by Positive Birth Movement founder Milli Hill, whose passion for improving childbirth shines out of every page.

The obvious comparison is with ‘How to Grow a Baby and Push It Out,’ being published around the same time and for a similar audience. But The Positive Birth Book is much less yummy mummy guidebook and more thinking woman’s handbook, with comprehensive chapters looking in depth at the decisions to make during pregnancy, the experience of labour, different kinds of support, ways of working with pain, and a lot less shopping.

Hill takes a strong evidence-based position, referring extensively to NICE guidelines, and with contributions from other very respectable authorities including Birthrights’ Rebecca Schiller and ABM Chair Emma Pickett. Usually I skip through the personal anecdotes, but they have been used really effectively in this book, breaking up an otherwise non-stop march of densely factual information.

A particular strength of The Positive Birth Book is the chapter describing what labour is “really like.” A tricky subject to cover, given all the possible individual experiences, and inevitably it’s a long chapter with some idiosyncratic but accurate descriptions. Hill goes on to argue the case for writing a birth plan, and she’s right that the process involves some engagement with the subject rather than washing one’s hands of any involvement in what might unfold. This is a difficult case to make, knowing that so many women struggle to come to terms with disappointment and grief when birth doesn’t meet their expectations. There is a good case for providing information and some decision-making strategies, which this book also does. A cute ‘visual birth plan’ tool is also offered.

A final chapter provides a taster of post-birth existence, touching on the fourth trimester concept, some basic but happily accurate information about breastfeeding, and postnatal feelings and changes. Here Hill signposts rather than going into much detail, since this would go beyond the remit of this already very detailed book.

I know that much inspiration and information for The Positive Birth Book was crowd-sourced, and the results have been articulately curated by Milli Hill into a really wonderful resource for pregnant women who are keen to do their research and take ownership of their birth experience.

[Disclaimer: I was sent a free review copy of The Positive Birth Book. You can get it from Pinter & Martin, with a 10% discount if you use the code SPROGCAST at the checkout.]