- Email: [email protected]
GYN
must endlessly be repeated in cycles of dying and rebirth, as expressed in groupfantasies which even today continue to determine much of our national political life.” The book ends with a rather interesting chapter written by an English professor on UFOs. He suggests UFO abduction reports are actually “fantasized sequenceIs] of images and events unconsciously based on the witness’ own perinatal memories” and presents some data to support his claim. In summary, although this is a very interesting book, much of it has no scientific base. Fantastic assertions are made with little or no supporting data. Often what is offered as supporting data is open to several interpretations. Much of this can be attributed to the very young nature of the field of pre- and peri-natal psychology and the difficulty doing controlled research in this area. Verny acknowledges that some of the presentations are open to the charge of being “unscientific” but maintains that “many of the things that truly matter to us as human beings, such as love, hate, beauty, honesty, creativity, and faith, cannot be quantified and elude traditional scientific inquiy.” Although this is true, psychology is not theology, philosophy, or art and should not be based on faith and subjectivity. If a writer asserts something to be a fact, he or she should be able to support it with scientific data. Where the data is weak or lacking, this should be acknowledged to the reader. Too often in this book, this is not done. Medical Complications During Pregnancy, 3rd Ed. Edited by Gerald N. Burrow, MD, and Thomas F. Ferris, MD. Philadelphia: W.B. Saunders Company, 1988. 603 pages. $70.00, hardcover. Reviewed by: Caron C. Campbell, CNM, ACNM Region 6Chapter 3, Auburn, WA.
MS, Chairperson,
Given the rapid evolution of knowledge in the sciences, the latest edition of this well-respected book fortunately comes only six years after the previous edition. In addition to contributing two chapters each themselves, Burrow and Ferris have chosen expert clinicians, professors, and researchers from many regions of North America to author chapters with in-depth information and recommended therapeutic management for medical problems affecting pregnancy.
192
All chapters have been updated since the second edition and a chapter on nutrition has been added. A reasonable proportion of the referenced material is new. In general, the material in this edition should serve the practitioner well for several years. However, readers will have to refer to other resources for the most current information on AIDS. In each chapter, a review of the physiology pertinent to each medical problem is provided as a framework for understanding the various medical therapies. If such details are not required by the reader, many titles and subtitles help in locating desired information. The index is very generous and also assists the reader in promptly finding specific material. Tables and figures summarize pathophysiology and therapeutic regimens. The book bends toward problem solving from an internal medicine rather than a typical obstetric perspective. An example is the first chapter, authored by editor Thomas Ferris, on toxemia and hypertension. A professor of medicine, Ferris’ approach is that of the internist. With compelling rationale, he advocates the aggressive use of antihypertensives and diuretics in the treatment of hypertension and toxemia. As in the second edition, he exhorts obstetricians to reevaluate the time-honored magnesium sulfate approach to this primary cause of maternal mortality. Although the editors have identified physicians as their intended audience, nurse-midwives will find the book useful for occasions when review of the pathophysiology of a medical problem or outline of medical therapeutics is needed. Realistically, the majority of complications in this book will probably be primarily managed by physicians. Nevertheless, many midwives will be in the position of explaining medical complications and therapies to their clients or comanaging them with physician consultation, instances in which the book can be a valuable resource. It is important to remember that this book is a product of medical academia and as such presents approaches and attitudes that do not always consider the day-to-day realities women with pregnancy complications have to face. Fortunately, midwives are skilled at taking the best of science and tempering it with a holistic, individualiing style of care. This excellent book, used in balance with cur-
rent journals and midwifery texts, deserves its proper place on every midwife’s bookshelf. Night Calls: The Personal Journey of an OB/GYN. By Henry Eisenberg, MD and Arlene and Howard Eisenberg. New York: Arbor House Publishing Company, 1986. 281 pages. $16.95, hardcover. Reviewed by: Lisa L. Paine, CNM, MS, MPH, The Johns Hopkins Hospital, Baltimore, MD, and N. Katherine Brown, BS, Towson State University, Baltimore, MD. Night Calls is Dr. Henry Eisenberg’s autobiographical account of his journey through medical school, residency, practice in the military, and eventually, private practice as an obstetrician. The underlying theme of this book seems to be the authors’ realization that in order to truly succeed as a respected professional, one must sometimes change one’s ideas and behaviors. Though he does emerge from his personal journey with characteristics that required changes in both ideas and behaviors, this theme is consistently overshadowed by the attitude the author communicates toward the women in both his practice and his personal life. When describing his admittedly unprofessional but human attraction to a “voluptuous” patient, Eisenberg remembers: “When I walked into the examining room and saw her, appearing even better put together under a gown than fully clothed, it took a great deal of willpower to thrust a not sufficiently fleeting fantasy from my mind.” The book is replete with professional anecdotes like the previous example which, although detailed and technically accurate, are demeaning in their tone and, should not be construed as typical of all OB/GYN providers. For example, in describing the details of a thorough breast exam, Eisenberg states that “when fim-~breasts run in the family, I may see a patient whose breasts, even after nursing four or five babies, appear almost as ‘good as new.’ Usually, though not always, they finally succumb to the aging process.” Any professional even remotely familiar with obstetrics might find these anecdotal accounts somewhat troubling. One such anecdote concerns Eisenberg’s memory of his experience during his ob-
Journal of Nurse-Midwifery
l
Vol. 33, No. 4, July/August 1988
stetrical residency. While in the delivery room, he found it necessary to verbally threaten another resident who was about to take away his patient. When the dust settled, Eisenberg recounted: “I position myself between Mrs. Gordon’s feet and tell the nurse firmly, ‘We’re ready to go.’ I notice the look of dismay on her face My patient, when I finally notice her, appears equally alarmed. Without comment, I proceed with the delivery. What is important is a good outcome. The emotional reactions of mothers and nurses are irrelevant. They play no part in the resident training curriculum.” Though the reviewers perceive that these accounts are Dr. Eisenberg’s attempt to relate negative experiences in terms of what happened and what he was thinking at that time, it is difficult to interpret whether these are still his present attitudes or simply accounts of his earlier ones. Given that his attitudes toward women are often negative, one area in which the author is noticeably respectful and not the least bit derogatory is in his handling of the topic of midwifery. Several times Eisenberg mentions midwives. Early on he gives a fairly elaborate historical account of the introduction of men into the obstetrical arena via male midwifery. In a later passage he describes the commitment of nurse-midwives to the support of childbirth preparation. Most notably, toward the latter part of the book, Eisenberg describes the collaborative arrangement he and his partner have with the nurse-midwife who joined them in private practice. Dr. Eisenberg seems to believe that his whole-hearted attempts to change should have earned him the reader’s understanding and forgiveness for his often inappropriate behavior as a novice professional. However, by the time the reader reaches the point where Dr. Eisenberg’s new attitudes are developed (not without the help of his wife and patients), it may be difficult to feel compassion and warmth toward this man. Having long ago enjoyed Dr. William Nolan’s The Making of a Surgeon, the reviewers approached Night Calls expecting an interesting and informative autobiography. Any reader expecting an insightful account of the rigors and travails of becoming a medical specialist will not find such introspection in Night Calls. Details of this journey in terms of the au-
Journal of Nurse-Midwifery
l
thor’s experiences and attitudes are presented, but the depth necessay to enable the reader to have compassion for the individual living through these experiences is conspicuously lacking. Hearts Open Wide: Midwives and Births. By Pam Wellish and Susan Root. Berkeley, CA: Wingbow Press, 1987. 253 pages. $9.95, softcover. Reviewed by: Patricia Paluzzi, CNM, Baltimore Birth Center, Baltimore, Maryland. This book is a collection of birth stones of women delivered by lay and nurse-midwives. It also includes the midwives’ stories of how they came to be midwives. The stories, originally put together as a tribute to the midwives in Northern California where all of the births took place, soon grew to book size and eventually became a national publication. Before beginning this book, I skeptically wondered, “How many midwives want to spend their free time reading birth stories when our lives are one continuous birth stay?” I soon found myself, however, eagerly awaiting the opportunity to read the next tale. Each story is unique; each author has her own style and although I personally did not learn anything new, it is always interesting to see how other midwives practice. It is also a good book for the general public. Not all of the home births described are completed at home and not all of the labors are without some intervention. In other words, the content is real and that fact is important to face for those who dream of perfect midwife-attended births. How many women suffer guilt or anger from shattered birth dreams? The book offers no great intellectual gain, but it doesn’t make that claim. If you like to read a few pages before turning out the lights, it’s ideal. Offering Hearts Open Wide to one’s pregnant clients may also help present some reality to those women whose knowledge of birth is limited and whose goals are not always attainable. It truly is a book for all women interested in birth. PerinataI AIDS: Infection Control for Hospital Personnel. Produced by Alvin Fiering. Released 1987. Revised February 1988. Color, sound, 17 minutes. Available in ?&inch and %-inch VHS
Vol. 33, No. 4, July/August 1988
and Beta video cassette from Polymorph Films, 118 South Street, Boston, MA 02111. l-800-223-5107 or (617) 542-2004. Purchase price $295.00; rental/preview $75.00 (deductible if purchased within 90 days). Should this program be revised in the future, older versions may be traded in for a $75.00 fee. Reviewed by: Margery Simchak, ESN, RN, ICEA CCE, Childbirth and women’s health educator, international writer and speaker, film critic, Phoenix, AZ. This video is about a current hot topic and is for all hospital obstetric health care providers. The content is presented on a basic level and is most pertinent to those providing direct care to obstetric patients. The objectives of the video are to present basic infection control measures specifically to obstetric and neonatal settings and to attempt to dispel some of the fears of misinformation about AIDS. Along with this information are the honest responses of several nurses and one patient. The video opens with three obstetric nurses talking about the first AIDS patient that was admitted to their unit. They were overwhelmed. “How many more are we going to get?’ and “How many have I had in the past that I did not know about?” were their immediate thoughts, Simple physiology of the human immunodeficiency virus (HIV) antibody is briefly explained. It is mentioned that although the virus has been isolated in many body fluids, it is felt that the most contaminated human sources are blood, semen, and vaginal secretions. The most common modes of transfer are sexual contact, exposure to infected blood, and from mother to newborn. Currently, the video notes, the Centers for Disease Control (CDC) recommends that the blood and body fluids of all patients be treated as potentially dangerous -a procedure called “universal precautions.” Important information about these precautions follows. When universal precautions are used with all patients, exposure is minimized and confidentiality is maintained for the AIDS patients while providing them quality care. These precautions for the obstetric unit include wearing gloves whenever coming in contact with blood or body fluids. Gloves should be washed or changed between patients. Masks should be used when
193
MS, Chairperson,
Given the rapid evolution of knowledge in the sciences, the latest edition of this well-respected book fortunately comes only six years after the previous edition. In addition to contributing two chapters each themselves, Burrow and Ferris have chosen expert clinicians, professors, and researchers from many regions of North America to author chapters with in-depth information and recommended therapeutic management for medical problems affecting pregnancy.
192
All chapters have been updated since the second edition and a chapter on nutrition has been added. A reasonable proportion of the referenced material is new. In general, the material in this edition should serve the practitioner well for several years. However, readers will have to refer to other resources for the most current information on AIDS. In each chapter, a review of the physiology pertinent to each medical problem is provided as a framework for understanding the various medical therapies. If such details are not required by the reader, many titles and subtitles help in locating desired information. The index is very generous and also assists the reader in promptly finding specific material. Tables and figures summarize pathophysiology and therapeutic regimens. The book bends toward problem solving from an internal medicine rather than a typical obstetric perspective. An example is the first chapter, authored by editor Thomas Ferris, on toxemia and hypertension. A professor of medicine, Ferris’ approach is that of the internist. With compelling rationale, he advocates the aggressive use of antihypertensives and diuretics in the treatment of hypertension and toxemia. As in the second edition, he exhorts obstetricians to reevaluate the time-honored magnesium sulfate approach to this primary cause of maternal mortality. Although the editors have identified physicians as their intended audience, nurse-midwives will find the book useful for occasions when review of the pathophysiology of a medical problem or outline of medical therapeutics is needed. Realistically, the majority of complications in this book will probably be primarily managed by physicians. Nevertheless, many midwives will be in the position of explaining medical complications and therapies to their clients or comanaging them with physician consultation, instances in which the book can be a valuable resource. It is important to remember that this book is a product of medical academia and as such presents approaches and attitudes that do not always consider the day-to-day realities women with pregnancy complications have to face. Fortunately, midwives are skilled at taking the best of science and tempering it with a holistic, individualiing style of care. This excellent book, used in balance with cur-
rent journals and midwifery texts, deserves its proper place on every midwife’s bookshelf. Night Calls: The Personal Journey of an OB/GYN. By Henry Eisenberg, MD and Arlene and Howard Eisenberg. New York: Arbor House Publishing Company, 1986. 281 pages. $16.95, hardcover. Reviewed by: Lisa L. Paine, CNM, MS, MPH, The Johns Hopkins Hospital, Baltimore, MD, and N. Katherine Brown, BS, Towson State University, Baltimore, MD. Night Calls is Dr. Henry Eisenberg’s autobiographical account of his journey through medical school, residency, practice in the military, and eventually, private practice as an obstetrician. The underlying theme of this book seems to be the authors’ realization that in order to truly succeed as a respected professional, one must sometimes change one’s ideas and behaviors. Though he does emerge from his personal journey with characteristics that required changes in both ideas and behaviors, this theme is consistently overshadowed by the attitude the author communicates toward the women in both his practice and his personal life. When describing his admittedly unprofessional but human attraction to a “voluptuous” patient, Eisenberg remembers: “When I walked into the examining room and saw her, appearing even better put together under a gown than fully clothed, it took a great deal of willpower to thrust a not sufficiently fleeting fantasy from my mind.” The book is replete with professional anecdotes like the previous example which, although detailed and technically accurate, are demeaning in their tone and, should not be construed as typical of all OB/GYN providers. For example, in describing the details of a thorough breast exam, Eisenberg states that “when fim-~breasts run in the family, I may see a patient whose breasts, even after nursing four or five babies, appear almost as ‘good as new.’ Usually, though not always, they finally succumb to the aging process.” Any professional even remotely familiar with obstetrics might find these anecdotal accounts somewhat troubling. One such anecdote concerns Eisenberg’s memory of his experience during his ob-
Journal of Nurse-Midwifery
l
Vol. 33, No. 4, July/August 1988
stetrical residency. While in the delivery room, he found it necessary to verbally threaten another resident who was about to take away his patient. When the dust settled, Eisenberg recounted: “I position myself between Mrs. Gordon’s feet and tell the nurse firmly, ‘We’re ready to go.’ I notice the look of dismay on her face My patient, when I finally notice her, appears equally alarmed. Without comment, I proceed with the delivery. What is important is a good outcome. The emotional reactions of mothers and nurses are irrelevant. They play no part in the resident training curriculum.” Though the reviewers perceive that these accounts are Dr. Eisenberg’s attempt to relate negative experiences in terms of what happened and what he was thinking at that time, it is difficult to interpret whether these are still his present attitudes or simply accounts of his earlier ones. Given that his attitudes toward women are often negative, one area in which the author is noticeably respectful and not the least bit derogatory is in his handling of the topic of midwifery. Several times Eisenberg mentions midwives. Early on he gives a fairly elaborate historical account of the introduction of men into the obstetrical arena via male midwifery. In a later passage he describes the commitment of nurse-midwives to the support of childbirth preparation. Most notably, toward the latter part of the book, Eisenberg describes the collaborative arrangement he and his partner have with the nurse-midwife who joined them in private practice. Dr. Eisenberg seems to believe that his whole-hearted attempts to change should have earned him the reader’s understanding and forgiveness for his often inappropriate behavior as a novice professional. However, by the time the reader reaches the point where Dr. Eisenberg’s new attitudes are developed (not without the help of his wife and patients), it may be difficult to feel compassion and warmth toward this man. Having long ago enjoyed Dr. William Nolan’s The Making of a Surgeon, the reviewers approached Night Calls expecting an interesting and informative autobiography. Any reader expecting an insightful account of the rigors and travails of becoming a medical specialist will not find such introspection in Night Calls. Details of this journey in terms of the au-
Journal of Nurse-Midwifery
l
thor’s experiences and attitudes are presented, but the depth necessay to enable the reader to have compassion for the individual living through these experiences is conspicuously lacking. Hearts Open Wide: Midwives and Births. By Pam Wellish and Susan Root. Berkeley, CA: Wingbow Press, 1987. 253 pages. $9.95, softcover. Reviewed by: Patricia Paluzzi, CNM, Baltimore Birth Center, Baltimore, Maryland. This book is a collection of birth stones of women delivered by lay and nurse-midwives. It also includes the midwives’ stories of how they came to be midwives. The stories, originally put together as a tribute to the midwives in Northern California where all of the births took place, soon grew to book size and eventually became a national publication. Before beginning this book, I skeptically wondered, “How many midwives want to spend their free time reading birth stories when our lives are one continuous birth stay?” I soon found myself, however, eagerly awaiting the opportunity to read the next tale. Each story is unique; each author has her own style and although I personally did not learn anything new, it is always interesting to see how other midwives practice. It is also a good book for the general public. Not all of the home births described are completed at home and not all of the labors are without some intervention. In other words, the content is real and that fact is important to face for those who dream of perfect midwife-attended births. How many women suffer guilt or anger from shattered birth dreams? The book offers no great intellectual gain, but it doesn’t make that claim. If you like to read a few pages before turning out the lights, it’s ideal. Offering Hearts Open Wide to one’s pregnant clients may also help present some reality to those women whose knowledge of birth is limited and whose goals are not always attainable. It truly is a book for all women interested in birth. PerinataI AIDS: Infection Control for Hospital Personnel. Produced by Alvin Fiering. Released 1987. Revised February 1988. Color, sound, 17 minutes. Available in ?&inch and %-inch VHS
Vol. 33, No. 4, July/August 1988
and Beta video cassette from Polymorph Films, 118 South Street, Boston, MA 02111. l-800-223-5107 or (617) 542-2004. Purchase price $295.00; rental/preview $75.00 (deductible if purchased within 90 days). Should this program be revised in the future, older versions may be traded in for a $75.00 fee. Reviewed by: Margery Simchak, ESN, RN, ICEA CCE, Childbirth and women’s health educator, international writer and speaker, film critic, Phoenix, AZ. This video is about a current hot topic and is for all hospital obstetric health care providers. The content is presented on a basic level and is most pertinent to those providing direct care to obstetric patients. The objectives of the video are to present basic infection control measures specifically to obstetric and neonatal settings and to attempt to dispel some of the fears of misinformation about AIDS. Along with this information are the honest responses of several nurses and one patient. The video opens with three obstetric nurses talking about the first AIDS patient that was admitted to their unit. They were overwhelmed. “How many more are we going to get?’ and “How many have I had in the past that I did not know about?” were their immediate thoughts, Simple physiology of the human immunodeficiency virus (HIV) antibody is briefly explained. It is mentioned that although the virus has been isolated in many body fluids, it is felt that the most contaminated human sources are blood, semen, and vaginal secretions. The most common modes of transfer are sexual contact, exposure to infected blood, and from mother to newborn. Currently, the video notes, the Centers for Disease Control (CDC) recommends that the blood and body fluids of all patients be treated as potentially dangerous -a procedure called “universal precautions.” Important information about these precautions follows. When universal precautions are used with all patients, exposure is minimized and confidentiality is maintained for the AIDS patients while providing them quality care. These precautions for the obstetric unit include wearing gloves whenever coming in contact with blood or body fluids. Gloves should be washed or changed between patients. Masks should be used when
193