book reviews | Motherworldly

08 Apr

Book review: The Roar Behind The Silence, edited by Sheena Byrom and Soo Downes

The first impression I had of The Roar Behind The Silence was that it is so densely packed: 50 chapters contributed by midwives, researchers, parents, obstetricians, doulas, antenatal teachers and one eloquent anaesthetist, covering such a huge range of thought: many different perspectives on why kindness, compassion and respect matter in maternity care.

Surely this ought to be a no-brainer. The implication that kindness, compassion and respect matter is right there in the word “care,” but it’s very clear from some of these stories that in our risk-averse culture, mothers are sometimes dehumanised in the baby production system. This is ground that has been covered by many authors, but Roar comes at a time when compassionate care is right in the headlines, a time when it is really important to agree on what this means, and how to make it happen.

The book is divided into three main sections. First, stories and persepctives from maternity care, including Mel Scott’s harrowing stillbirth story, and obstetrician Alison Barrett’s understanding of where the midwife stands from the consultant’s perspective. Next, principles and theories underpinning current practice and possible new ways of working. And finally Making it happen: solutions from around the world – both in terms of global experience, and different approaches to practice. This last section is probably the most useful and informative, setting the bar much higher than a healthy baby as the only valued outcome.

Most of the chapters are short and the book could be read in an ad hoc way; however I found most of the contributions compelling, and read it straight through, making a few notes. I was struck by the prevalence of social media in many of the chapters, as a way to share experience and compassion with colleagues and other interested parties; though it might also be worth acknowledging the downside of potential for kneejerk reactions in such a public space.

I particularly enjoyed the two contributions from anaesthetist Robin Youngson, who perfectly summarises the impact of relationships – good and bad – and the importance of kindness in all aspects of care. Which should, as I said, be a no-brainer.

I’m hoping to talk to co-editor Sheena Byrom for our next episode of Sprogcast, and looking forward to asking her how she chose and organised the contributions.

Disclosure: Mark very kindly sent me a copy of this book!

12 Feb

Book review: Guilt-Free Bottle Feeding, by Madeleine Morris

The stated purpose of the book Guilt-Free Bottle Feeding is to debunk the myth that mothers should feel guilty if they do not breastfeed, and to provide objective, evidence-based information about bottle feeding and formula. It meets this second aim admirably, with clear and detailed sections on different formulas and tried and tested techniques. This final 45 pages of the book would be an extremely useful resource particularly for Breastfeeding Counsellors who are encountering an increasing number of questions and requests for support around formula.

The bulk of the book, however, features an army of straw men, and is written in a hectoring, defensive tone, with many statements about “lactivists” which border on being offensive. For an example of all of the above, see page 137 where the zealous lactivists deliberately manipulate and prey upon mothers’ emotions; page 138 where breastfeeding advocates’ real agenda is “to make formula feeding parents feel like shit;” and the jaw-dropping claim on page 88 that there is money to be made from breastfeeding support.

Morris’ writing is very much embedded in her personal experience of breastfeeding and her feelings about it, supported by her friend Dr Sasha Howard who also shares her own experience of breastfeeding as well as that of supporting families as a paediatrician. They exhort a change in message on feeding choices, asking for more realistic, nuanced antenatal breastfeeding education, to include more detail on formula feeding; and more compassion for mothers who do not breastfeed. If this sounds frustratingly familiar, that’s because this is very much in line with NCT’s current Infant Feeding Message Framework.

Unfortunately the way Morris presents this itself lacks nuance and understanding of how breastfeeding support works. She is deeply opposed to any language of risk, positing that rather than enabling informed choice, this language comes across as bullying and guilt-inducing. Reading this book made me doubt the validity of my own perspective on breastfeeding; could it really be true that the media is completely biased towards breastfeeding (p.90-96), that no celebrity ever makes a negative statement about her own breastfeeding experience (9.108), and that breastfeeding “advocates” wilfully misrepresent the research on breastmilk in order to pressure mothers (p.75)? Could my bias really be so deeply embedded that I don’t see this at all? Then I would definitely have to identify myself with the lactivists.

This book provides a great deal of material upon which to reflect. Morris’ sadness and anger about her own experience of breastfeeding and of not breastfeeding undermine her claims of objectivity. Much of this anger is directed towards breastfeeding supporters. She has had no difficulty in finding case studies: 15 of them, only three of which are about women who had no intention of breastfeeding. The others are women who were – in her words – “forced to bottle-feed.” (p.47). This seems a strong enough argument for not destroying women’s confidence in the people who could help them.

Where ‘Guilt-Free Bottle Feeding’ comes into its own is in the genuinely objective and useful practical section, but the preceding 150 pages are a tough read, and tell us nothing that we do not already know about perceptions of breastfeeding support.

Disclosure: I was given a free review copy of this book.
Views expressed here are my own, and do not represent the views of NCT.

24 Nov

Book Review: Sweet Sleep, from La Leche League

Sweet Sleep is a La Leche League publication, written by some of the well-known names in the LLL world: Diane Wiessinger, Diana West, Linda J. Smith and Teresa Pitman; and as such it sets out a very definitely baby-centred philosophical position, as you might expect. It very nearly does manage to achieve a balanced tone with regard to the fact that not all families breastfeed, and even includes a chapter on how to cope if you don’t have this powerful parenting tool available to you (adoptive families, for instance), but its subtitle clearly states “for the Breastfeeding Family” and this is where its real strength lies.

There is a wealth of advice available online, from health professionals, and among families and friends, for parents who want techniques to “train” their babies to sleep. Sweet Sleep fills a gap for the parents who want to work within their babies’ normal development, with gentle nudges from stage to stage, but allowing for kind and responsive parenting.

Sweet Sleep is packed with practical suggestions, and sensibly begins with a chapter full of immediate ideas for getting more sleep tonight. It focuses straight away on the Safe Sleep Seven, which are rules for emergency bedsharing. Given that statistics show unplanned bedsharing to be far riskier than planned bedsharing, helping parents to plan for it is a really good place to start.

It goes on to explain normal sleep, drawing on anthropology, biology, and worldwide cultural practices. This is followed by safety information, gentle nudges for different ages and stages, and suggestions for different scenarios such as premature babies, twins and so on. The chapter on SIDS and suffocation is comprehensive and well-explained; and finally the book offers suggestions for talking to supportive and non-supportive people about an attachment parenting approach to coping with nights.

This book is well-referenced throughout, and illustrated with quotes from the authors’ own stories and from other families. Once too often I found myself frustrated that the authors touch on a point and promise to explain it more in a later chapter, making me dip about in the book rather than reading it through as I wanted to. I was not particularly surprised that the section on Getting Help/Giving Help only mentions La Leche League, when there are quite a number of other organisations, including NCT, who could also support parents in these situations.

On the whole I found this book useful both in terms of practical help for parents of co-sleeping/breastfeeding babies, and ways of thinking/talking about risk and responsiveness, which I find a lot of new parents and parents-to-be worry about. It’s good to have a book that supports parents to follow their instincts and find their own rhythms.

DISCLOSURE: I was sent a free review copy of this book by Pinter and Martin Publishers. To order your own copy with a 25% discount, just follow the link and use the discount code KH25 at the checkout.

11 Jul

Book Review: Nurturing new families, by Naomi Kemeny

Naomi Kemeny is an experienced postnatal doula and has written Nurturing New Families for anyone supporting parents of newborn babies. It has useful chapters for grandparents and friends as well as for postnatal doulas, particularly those starting out. It gives a good background on why postnatal support is so important in 21st Century Britain, and a useful overview of the needs of mothers and babies in those challenging early weeks. There are also sections for special situations such as single mothers, twins and multiples, postnatal depression, families with pets, and other circumstances.

All of this is relevant in whatever capacity the reader is supporting new parents, but it is difficult to tell who would buy this book; new grandparents might find that there is too much advice for doulas, and vice versa. It might, however, be very useful for a grandparent to understand the value of a doula.

I was quite surprised that Murkoff et al’s What To Expect The First Year (described by Naomi Wolf with scathing accuracy as “the intellectual equivalent of an epidural” in her book Misconceptions) is Kemeny’s idea of “an excellent reference manual.” (p.33). I can think of about twenty books I would rather have to hand, and actually Nurturing New Families could be one of them.

There are some excellent guidelines on empathic listening, which is hard to do when you’re close to the person you’re supporting, so this of course is useful for grandmothers and friends, but essential for doulas. I strongly agree with Kemeny’s advice to take the opportunity to debrief one’s own breastfeeding experience before trying to support someone else with its particular challenges.

Some of the book is a little repetitive, for example the advice on page 68 for grandparents is repeated on page 136 for doulas, and some of the quotations are pulled from the stories at the back. The book is so full of useful stuff that it does not need this kind of padding, but I feel I am being picky. It’s a useful book, and I would have found it really handy in my early work as a postnatal doula. I would recommend it to someone at the beginning of their doula career, as it covers a good range of different situations and is full of sensible advice.

[Disclosure: I was given a free review copy of Nurturing New Families]

03 Jul

Book Review: Life After Birth, by Kate Figes

Kate Figes seems to make a living writing about how awful things are. According to her, birth is awful, and motherhood is awful, and if you haven’t done either of these things yet, this book is pretty certain to put you right off. Reading it during pregnancy would be an extremely bad idea.

In keeping with the genre, Figes presents her rationale, which is that motherhood is difficult and lonely and nobody tells you that beforehand. Here she is in good company; Rachel Cusk‘s slightly depressing motherhood memoir comes to mind. In fact so many authors have written about how nobody tells you how awful motherhood is, that I’m starting to suspect that it might not be true.

Despite the age (2000) of my edition, Life After Birth sets out the context with an explanation which remains topical today, explaining how birth has become so safe for women, that the focus is now almost exclusively on the wellbeing of the baby (see our review of Optimal Care in Childbirth for the bang-up-to-date, academic version of this). However, in a tone of thin sarcasm, most of the book delves into all the things it is possible for a mother to do wrong, and presents motherhood as unfeminist and slightly idiotic.

On the front cover, a quote from The Times describes Life After Birth as a manual; but it would be disingenuous to describe this as a manual, since nowhere does it contain suggestions, strategies or support for the wide range of unpleasant experiences she describes. What comes across is a series of rather peevish attempts to justify her own feelings and decisions; for example in her attempt to debunk the well-evidenced attachment theory on page 63, and her language when referring to authors with whom she clearly disagrees, namely Deborah Jackson (“Leaving a child to cry himself back to sleep apparently teaches him to be resigned to his impotence” – my emphasis – p.117) and Sheila Kitzinger, who “believes” that certain babies are more likely to have sleep problems (p.119). It’s a shame she doesn’t adopt this same circumspect tone when advocating homeopathy to aid recovery from a Caesarean birth, on page 32.

Each chapter contains enough references to give the impression of academic authority, and these hang together with a long string of generalisations and personal anecdotes, rendering the whole thing fairly meaningless. For example, pregnant women “are unlikely to have close friends who are also pregnant.” (p.143) and “Women on the other hand find themselves suddenly defenceless and dependent on a man they may not altogether trust.” (p.145).

Reading this makes me feel sad for whatever complex awfulness this woman went through in her relationships when she became a mother, but it is hard to identify with much in this book, even having been on my own rollercoaster of motherhood only a few years ago. Naomi Stadlen shows that it is possible to be honest and realistic about motherhood without painting an entirely bleak picture. As for Kate Figes, the positive aspects of motherhood finally get a whole paragraph on the last page, but I’m afraid these fears of “being labelled ‘selfish,’ ‘immature’ or ‘not fit to be a mother,'” (p.245) are far from universal, and if these are your fears, this is not the book to help resolve them.

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 →