- Email: [email protected]
Giving birth: Alternatives in childbirth
described as Mr. McCarthy on the cover of the book. The case examples in the book apparently are taken from couples he has treated. The book is composed primarily of recommended exercises, some for the individual, but most for the couple. These exercises are based on behavioral and social learning theory and are very similar to those previously recommended by such leaders in the field as Masters and Johnson, Helen Singer Kaplan, Hartman and Fithian, Lonnie Barbach, and Joseph Lopiccolo. These exercises emphasize openness, communication, and experimentation without performance demands or making intercourse into a “detached and impersonal gymnastic feat.” The McCarthys avoid the typical marriage manual approach of detailing numerous coital positions and the implied message that to be a good lover you have to be a masterful technician. On the negative side, the exercises tend to be somewhat redundant and often the case studies add little to the content. For example, the point of one four-page case report (pages 137-140) seems quite obscure. Also, the McCarthy’s position on sexual fantasies is extremely confusing, even contradictory. They advise against acting out most sexual fantasies and then immediately recommend an exercise doing just that. Finally, their chapter on sex and aging does not deal either with the important factors of exercise and nutrition or with the largely unfounded fear many have that coitus will precipitate a heart attack. At the end of the book the authors note that the book is not a substitute for a sex or marital therapist and suggest ways a couple may locate a therapist. The book ends with a suggested reading list but unfortunately there is neither an index nor a glossary. Despite its weaknesses, this book would be useful for well-motivated couples whose sexual problems are not too severe. It might also be a helpful adjunct to professional sex therapy in more severe cases. About Conception
and Contraception.
Color, no sound, 11 minutes. Produced by Perennial Education, Inc., 1973. Available in 16-mm and videocassette cartridges. Available from Perennial Education, Inc., 930 Pitner Avenue, Evanston, IL 60202. (312)328-6700. Purchase price: $235.00; rental, $22.00. 354
Reviewed by: Lois C. Olsen, CNM, MSN, Associate Professor, University of Wisconsin-Milwaukee, Milwaukee, WI.
Done with cartoons, and no sound, this film demonstrates both conception and contraception. The drawings are explicit and anatomically correct. All major forms of contraception are illustrated including male and female sterilization. The film is very short so there are no lengthy descriptions. There is no discussion regarding the advantages, disadvantages, or contraindications of each method. The film is suitable for teenagers, nonEnglish-speaking clients, and undergraduate college students. Viewers, however, should note that because the film was produced in 1973 some currently available contraceptive devices are not mentioned. Giving Birth: Alternatives in Childbirth. By Barbara Katz Rothman, Phn.
New York: Penguin Books, 1982. 320 pages. $6.95, softcover. by: Lois C. Olsen, CNM, MSN, University of Wisconsin-Milwaukee, Milwaukee, WI. Reviewed
This book presents a series of antagonistic dyads relating to pregnancy and birth. A persistent theme is the comparison of the medical, male, pathological view of childbearing as opposed to the midwifery, female, holistic view. In this discussion, a major question revolves around the locus of control: Is it the physician or is it the woman who is pregnant? The interest in the subject arose from the author’s home birth. Although that birth was directed by an obstetrician, the author compares the home birth with the more technological orientation of a hospital birth. She calls the first a midwifery model and the second a medical model; for the home birth can be directed medically and the hospital birth can be oriented to the midwifery model. Part I of the book discusses the politics of maternity care. There is a brief history of maternity care that emphasizes that for centuries, childbirth and midwifery were not a part of medicine. It was in the 18th century that male physicians began to appropriate the care of the laboring woman. Increasingly, the struggle between midwives and physicians related to fees, mastery of knowledge, and competition for patients. In the United States, Journal of Nurse-Midwifery
??
the male physicians almost completely obliterated the midwifery profession, but not quite. There is a brief but adequate history of nurse-midwifery in the United States. There is also a short discussion of whether or not American nurse-midwives have sold out to the medical model, making their practice conform to medical standards. This section also deals with the issue of feminists versus traditionalists. “The struggle around childbirth is essentially a question of autonomy and control, a basic power issue” (page 95). While both feminists and traditionalists challenge the medical model and the profession of medicine, the feminists venture beyond that and challenge the patriarchal family structure. The feminists insist that women have the right to decide whether or not and when to have babies as well as how and where to have babies. This question of control pertains to such issues as abortion, breast-feeding, and pain relief and support in labor. Part II deals with aspects of maternity care in America. It deals with topics of infertility, toxemia, prenatal care, infant feeding, and parental bonding. There is a discussion as to the limits of normal in pregnancy. For example, since the drop in hematocrit in pregnancy is the result of normal physiology, is it a matter of concern? Does the administration of oral iron and folic acid provide any benefits to the mother and fetus? Numerous studies demonstrate that they have no effect. Their use is a part of that attitude that pregnancy is pathological and requires treatment. The lengthy discussion on infant feeding provides strong arguments for breast-feeding. Not only is breast milk more suited to the infant than formula, but it provides disease protection and is indicative of the physiologic interdependence of mother and infant. Part III deals with the role and function of the nurse-midwife in current maternity care. There are descriptions of nursemidwives who function in birth centers and those doing home births. Nurse-midwives in the latter instances alter their views on the conduct and progress of labor. “Giving birth at home changes things” (page 246). It changes the locus of control from the practitioner to the mother. There is a long discussion on what constitutes a normal labor. The author compares the figures in William’s Obstetricsto Mehl’s study of home births. The
Vol. 30, No. 6, November/December
1985
plea is for nonintervention based solely on duration of labor. The final section is a point by point comparison of the medical versus the midwifery model. For example the medical model considers the fetus as a parasite on the maternal system, as well as a child of the mother growing inside of the woman. The midwifery model views the fetus and the woman as a single unit: meeting the needs of one meets the needs of the other. This book should be on the reading list of every nurse-midwife. It helps to define not only the politics of maternity care but also the philosophical differences in care given by physicians and nurse-midwives. It should help us clarify our views of pregnancy as a normal physiologic process and thus define our practice. The book occasionally is dated. Although orginally published in 1982, it was apparently written about 1978. Some aspects of maternity care have changed. For instance, there has been a significant turn around in the instances of breast-feeding. It is no longer common practice to treat weight gain with strict diets and diuretics. The book primarily deals with childbirth in the United States with occasional references to the rest of the world. Midwifery practice in England receives brief attention. With the bulk of births in other countries managed by midwives, it would have been helpful to compare maternity care in those areas, particularly in Europe where infant mortality is considerably lower than in our country. Condom Sense. Color, sound, 25 minutes. Produced by Jim Locker, 1982. Available in 16-mm and videocassette cartridges. Available from Perennial Education, Inc., 930 Pitner Avenue, Evanston, IL 60202. (312)328-6700. Purchase price: $287.00; rental, $34.00. Reviewed by: Lois C. Olsen, CNM, MSN, Associate Professor, University of Wisconsin-Milwaukee, Milwaukee, WI. As the title suggests, information about the condom is presented with humor and puns. However, the film’s intent and technical content are serious and effective. There is a special effort to emphasize the male role in use of the condom and the importance of his initiation and acceptance of responsibility for contraception.
Journal of Nurse-Midwifery
??
There is a clear discussion of the types of condoms, the reasons for using them, their availability, and effectiveness rates. A clever description of the application process is done with a man and a large rubber tube. This film is suitable for client education and would be especially effective for classroom use with adolescent students. Health Care of Women: Labor and Delivery. By Beverly Gorvine, et al. Belmont, California: Wadsworth Health Sciences Division, 1982. 128 pages. $15.95, hardcover. Reviewed by: Evelyn E. Brown, CNM, Clinical Assistant Professor, State University of New York, Downstate Medical Center, College of Health Related Professions, Nurse-Midwifery Program, Brooklyn, NY.
MPH,
Health Care of Women: Labor and Delivery is written in an easy-to-read manner. It is designed for nurses working with women and families in labor and delivery. The authors also consider this text appropriate for undergraduate and graduate students in advanced practice, childbirth educators, and for monitrices. They further state, “As a supplement to basic maternity and pediatric nursing textbooks, this book provides in-depth coverage of all aspects of nursing intervention during this critical period.” The text is designed to follow the four steps of the nursing process, incorporating theories of crisis intervention and use of the problem-oriented medical record format. The contents are selected to meet three objectives: 1) provision of comprehensive materials on assessment during labor, delivery, and the immediate neonatal period; 2) delineation and implementation of nursing interventions; and 3) evaluation of nursing care. The chapters pertaining to interviewing skills, initial admission assessment, and parent-infant bonding are a basic adjunct to reading materials, which could be used by health care providers who come into contact with the woman and her family during the labor and delivery process. Despite the brevity of the book, the authors have included a review of petlinent anatomy and physiology of the uterus, pelvis, and fetal skull, and the onset of and mechanisms of labor during the first and second stages. However,
Vol. 30. No. 6, November/December
1985
there is no mention of the other organs or structures of reproduction, or the physiology and mechanism of the very important third stage of labor. Great emphasis has been placed on the essentials of assessment and reassessment of the woman and fetus during a normal labor. This information is of vital importance and should be adhered to by both the clinician and nursing personnel who are responsible for the management and care of the woman in labor. The chapter that discusses care of the newborn emphasizes the responsibility of the labor-room nurse, and also gives general instructions for immediate care of the normal as well as the mildly and moderately depressed infant. Also included in the text are outlines of possible risk factors that may be present when the practitioner cares for the at-risk woman and her infant. This information can by synthesized by the clinician who has a solid knowledge of the subject matter. The final chapter briefly addresses birthing alternatives which, to quote the writers “is included as an update on trends that have an impact on health care delivery to women in labor.” This is presented in a vey positive way by the authors who discuss hospital birthing rooms, home births, and birthing centers. This information should help to increase the clinicians’ sensitivity to the family’s need for alternatives in birthing. Other strong points that should be mentioned are: 1) each chapter begins with a specific list of objectives and ends with a practical “test yourself” clinical situation; and 2) the references are numerous and are referred to throughout the book. Readers are given the opportunity to review the reference material for clarification of the subject presented, which also should help him/her to answer the “test yourself’ questions and subsequently meet the objectives. This book should only be used as a supplement to more detailed texts on the subject because it does not address the specific techniques that are essential components of the clinicians’ management skills.
Coping With Caring for Sick Newborns. By Richard E. Marshall, MD, Christine Kasman, MSW, ACSW, and Linda S. Cape, RN, MSN. Philadelphia: W. B. Saunders Company, 1982. 292 pages. $14.95, softcover; $14.95, hardcover.
355
and Contraception.
Color, no sound, 11 minutes. Produced by Perennial Education, Inc., 1973. Available in 16-mm and videocassette cartridges. Available from Perennial Education, Inc., 930 Pitner Avenue, Evanston, IL 60202. (312)328-6700. Purchase price: $235.00; rental, $22.00. 354
Reviewed by: Lois C. Olsen, CNM, MSN, Associate Professor, University of Wisconsin-Milwaukee, Milwaukee, WI.
Done with cartoons, and no sound, this film demonstrates both conception and contraception. The drawings are explicit and anatomically correct. All major forms of contraception are illustrated including male and female sterilization. The film is very short so there are no lengthy descriptions. There is no discussion regarding the advantages, disadvantages, or contraindications of each method. The film is suitable for teenagers, nonEnglish-speaking clients, and undergraduate college students. Viewers, however, should note that because the film was produced in 1973 some currently available contraceptive devices are not mentioned. Giving Birth: Alternatives in Childbirth. By Barbara Katz Rothman, Phn.
New York: Penguin Books, 1982. 320 pages. $6.95, softcover. by: Lois C. Olsen, CNM, MSN, University of Wisconsin-Milwaukee, Milwaukee, WI. Reviewed
This book presents a series of antagonistic dyads relating to pregnancy and birth. A persistent theme is the comparison of the medical, male, pathological view of childbearing as opposed to the midwifery, female, holistic view. In this discussion, a major question revolves around the locus of control: Is it the physician or is it the woman who is pregnant? The interest in the subject arose from the author’s home birth. Although that birth was directed by an obstetrician, the author compares the home birth with the more technological orientation of a hospital birth. She calls the first a midwifery model and the second a medical model; for the home birth can be directed medically and the hospital birth can be oriented to the midwifery model. Part I of the book discusses the politics of maternity care. There is a brief history of maternity care that emphasizes that for centuries, childbirth and midwifery were not a part of medicine. It was in the 18th century that male physicians began to appropriate the care of the laboring woman. Increasingly, the struggle between midwives and physicians related to fees, mastery of knowledge, and competition for patients. In the United States, Journal of Nurse-Midwifery
??
the male physicians almost completely obliterated the midwifery profession, but not quite. There is a brief but adequate history of nurse-midwifery in the United States. There is also a short discussion of whether or not American nurse-midwives have sold out to the medical model, making their practice conform to medical standards. This section also deals with the issue of feminists versus traditionalists. “The struggle around childbirth is essentially a question of autonomy and control, a basic power issue” (page 95). While both feminists and traditionalists challenge the medical model and the profession of medicine, the feminists venture beyond that and challenge the patriarchal family structure. The feminists insist that women have the right to decide whether or not and when to have babies as well as how and where to have babies. This question of control pertains to such issues as abortion, breast-feeding, and pain relief and support in labor. Part II deals with aspects of maternity care in America. It deals with topics of infertility, toxemia, prenatal care, infant feeding, and parental bonding. There is a discussion as to the limits of normal in pregnancy. For example, since the drop in hematocrit in pregnancy is the result of normal physiology, is it a matter of concern? Does the administration of oral iron and folic acid provide any benefits to the mother and fetus? Numerous studies demonstrate that they have no effect. Their use is a part of that attitude that pregnancy is pathological and requires treatment. The lengthy discussion on infant feeding provides strong arguments for breast-feeding. Not only is breast milk more suited to the infant than formula, but it provides disease protection and is indicative of the physiologic interdependence of mother and infant. Part III deals with the role and function of the nurse-midwife in current maternity care. There are descriptions of nursemidwives who function in birth centers and those doing home births. Nurse-midwives in the latter instances alter their views on the conduct and progress of labor. “Giving birth at home changes things” (page 246). It changes the locus of control from the practitioner to the mother. There is a long discussion on what constitutes a normal labor. The author compares the figures in William’s Obstetricsto Mehl’s study of home births. The
Vol. 30, No. 6, November/December
1985
plea is for nonintervention based solely on duration of labor. The final section is a point by point comparison of the medical versus the midwifery model. For example the medical model considers the fetus as a parasite on the maternal system, as well as a child of the mother growing inside of the woman. The midwifery model views the fetus and the woman as a single unit: meeting the needs of one meets the needs of the other. This book should be on the reading list of every nurse-midwife. It helps to define not only the politics of maternity care but also the philosophical differences in care given by physicians and nurse-midwives. It should help us clarify our views of pregnancy as a normal physiologic process and thus define our practice. The book occasionally is dated. Although orginally published in 1982, it was apparently written about 1978. Some aspects of maternity care have changed. For instance, there has been a significant turn around in the instances of breast-feeding. It is no longer common practice to treat weight gain with strict diets and diuretics. The book primarily deals with childbirth in the United States with occasional references to the rest of the world. Midwifery practice in England receives brief attention. With the bulk of births in other countries managed by midwives, it would have been helpful to compare maternity care in those areas, particularly in Europe where infant mortality is considerably lower than in our country. Condom Sense. Color, sound, 25 minutes. Produced by Jim Locker, 1982. Available in 16-mm and videocassette cartridges. Available from Perennial Education, Inc., 930 Pitner Avenue, Evanston, IL 60202. (312)328-6700. Purchase price: $287.00; rental, $34.00. Reviewed by: Lois C. Olsen, CNM, MSN, Associate Professor, University of Wisconsin-Milwaukee, Milwaukee, WI. As the title suggests, information about the condom is presented with humor and puns. However, the film’s intent and technical content are serious and effective. There is a special effort to emphasize the male role in use of the condom and the importance of his initiation and acceptance of responsibility for contraception.
Journal of Nurse-Midwifery
??
There is a clear discussion of the types of condoms, the reasons for using them, their availability, and effectiveness rates. A clever description of the application process is done with a man and a large rubber tube. This film is suitable for client education and would be especially effective for classroom use with adolescent students. Health Care of Women: Labor and Delivery. By Beverly Gorvine, et al. Belmont, California: Wadsworth Health Sciences Division, 1982. 128 pages. $15.95, hardcover. Reviewed by: Evelyn E. Brown, CNM, Clinical Assistant Professor, State University of New York, Downstate Medical Center, College of Health Related Professions, Nurse-Midwifery Program, Brooklyn, NY.
MPH,
Health Care of Women: Labor and Delivery is written in an easy-to-read manner. It is designed for nurses working with women and families in labor and delivery. The authors also consider this text appropriate for undergraduate and graduate students in advanced practice, childbirth educators, and for monitrices. They further state, “As a supplement to basic maternity and pediatric nursing textbooks, this book provides in-depth coverage of all aspects of nursing intervention during this critical period.” The text is designed to follow the four steps of the nursing process, incorporating theories of crisis intervention and use of the problem-oriented medical record format. The contents are selected to meet three objectives: 1) provision of comprehensive materials on assessment during labor, delivery, and the immediate neonatal period; 2) delineation and implementation of nursing interventions; and 3) evaluation of nursing care. The chapters pertaining to interviewing skills, initial admission assessment, and parent-infant bonding are a basic adjunct to reading materials, which could be used by health care providers who come into contact with the woman and her family during the labor and delivery process. Despite the brevity of the book, the authors have included a review of petlinent anatomy and physiology of the uterus, pelvis, and fetal skull, and the onset of and mechanisms of labor during the first and second stages. However,
Vol. 30. No. 6, November/December
1985
there is no mention of the other organs or structures of reproduction, or the physiology and mechanism of the very important third stage of labor. Great emphasis has been placed on the essentials of assessment and reassessment of the woman and fetus during a normal labor. This information is of vital importance and should be adhered to by both the clinician and nursing personnel who are responsible for the management and care of the woman in labor. The chapter that discusses care of the newborn emphasizes the responsibility of the labor-room nurse, and also gives general instructions for immediate care of the normal as well as the mildly and moderately depressed infant. Also included in the text are outlines of possible risk factors that may be present when the practitioner cares for the at-risk woman and her infant. This information can by synthesized by the clinician who has a solid knowledge of the subject matter. The final chapter briefly addresses birthing alternatives which, to quote the writers “is included as an update on trends that have an impact on health care delivery to women in labor.” This is presented in a vey positive way by the authors who discuss hospital birthing rooms, home births, and birthing centers. This information should help to increase the clinicians’ sensitivity to the family’s need for alternatives in birthing. Other strong points that should be mentioned are: 1) each chapter begins with a specific list of objectives and ends with a practical “test yourself” clinical situation; and 2) the references are numerous and are referred to throughout the book. Readers are given the opportunity to review the reference material for clarification of the subject presented, which also should help him/her to answer the “test yourself’ questions and subsequently meet the objectives. This book should only be used as a supplement to more detailed texts on the subject because it does not address the specific techniques that are essential components of the clinicians’ management skills.
Coping With Caring for Sick Newborns. By Richard E. Marshall, MD, Christine Kasman, MSW, ACSW, and Linda S. Cape, RN, MSN. Philadelphia: W. B. Saunders Company, 1982. 292 pages. $14.95, softcover; $14.95, hardcover.
355