Obstetrics and the newborn

Baltimore: Williams and Wilkins, 1985. 219 pages. $39.50, hardcover. Reviewed

by: Peggy Visher, CNM, MSN, Private Practice, Brooklyn, NY.

This book provides a concise presentation of pelvic infections in the female patient. The first five chapters, written by Sebastian Faro, are consistent and accurate in the information provided. The second five chapters, with contributions by various authors, vary in quality and are generally not as well written as the first half of the book. There are also several editing and typographical errors, which are easy to recognize since they are so obviously wrong. Dr. Faro, the Director of Infectious Diseases at Baylor University, discusses the various types of bacteria indigenous to the normal vaginal flora, those which are introduced and cause infection, and the dual role of many of the bacteria. The thoroughness of his explanation of the microbiology of the bacterial infections, in conjunction with his discussion of pelvic physiology, make the material understandable to practitioners with varying levels of education. He then presents a chapter on the evaluation of the infected patient and discusses various antibiotic agents in terms of their specific action and toxic effects. The strongest (and longest) chapter in the book is the one on sexually transmitted diseases. The etiology and epidemiology are discussed, as well as clinical manifestations, diagnosis, and treatment. There are numerous charts of patient evaluation schemes, showing differential diagnoses of similar infections. The chapter on pelvic inflammatory disease is equally as thorough in its presentation. Both of these chapters are good references for any practitioner in the field of women’s health care. The main weakness of these chapters, and throughout the whole book, is the fact that most of the references are from the 1970s. Some of the treatment modalities presented in the book have changed in the past 15 years. Subjects covered in the last five chapters include tubo-ovarian abscess, puerperal infection, urinary tract infections (UTI) (nosocomial and during pregnancy), and infections following gynecological operations. The chapters on urinay tract infections are the weakest and have the most inconsistencies. For ex-

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ample, in one section the author states that nitrofurantoin is contraindicated in term pregnancy and in another section suggests its prophylactic use throughout the pregnancy, in women with recurrent UTIs. However, the pathophysiology, microbiology, and review of the literature are strong in the UT1 chapters. In summary, though this book is probably not updated in terms of treatment regimes, it does provide thorough information about causative factors and differential diagnosis of female pelvic infections. The book is presented in an organized format with key points emphasized in the margins. It is a good basic reference, even though it may be necessary to consult other sources for more recent treatment modalities. How To Make Sure Your Baby Is Well . . . And Stays That Way. By Herbert A.

Haessler, MD, with Christine and Raymond Harris. New York Rawson Associates, 1984. 347 pages. $17.95, hardcover. Reviewed by: Lyn Finelli, MS, CPNP, Associate in Nursing, Columbia University School of Nursing, New York, NY. How To Make Sure Your Baby Is Well and Stays That Way is a misguided

and impractical book. Dr. Haessler sets about teaching parents how to detect heart murmurs and abnormal lung sounds and how to elicit vestibular nystagamus. In the process, regrettably, subtle techniques and technical information are bandied about like cookbook recipes. For instance, the differences between patches and plaques are described so that skin lesions may be diagnosed. However, those who have evaluated rashes know that precision of diagnosis results primarily from clinical experience with skin disorders. Dr. Haessler’s compact recipes cannot nearly suffice, and can be expected to yield, in the main, unnecessary alarm and anxiety. The book consists of 17 chapters, the first of which discusses the newborn examination. In chapters 2-12, Dr. Haessler approaches the physical examination systematically-from skin through the endocrine system. The final five chapters cover miscellaneous topics such as tracking and testing growth and development, and recognizing and dealing with medical emergencies. This reviewer is fully in favor of em-

Journal of Nurse-Midwifery

powering people with the responsibility for their health. However, the inform& tion provided here, while accurate, is unlikely to help. It is far too technical and will surely produce confusion and alarm in untrained parents who have no baseline for comparison. Dr. Haessler implies that good, concerned parents have an obligation to their child to purchase the necessary equipment (stethoscope, otoscope) and perform quite detailed examinations routinely. This reviewer disagrees. It is surely a pleasure to care for a well-informed, concerned public. However, Dr. Haessler’s book does not achieve that end. Obstetrics and the Newborn, 2nd Edition. By Norman A. Beischer, MD, and Eric V. Mackay, MD. Philadelphia: W. B. Saunders Company, 1986. 744 pages. $39.95, hardcover. Reviewed

by: Jaynelle F. Stichler, RN, Managing Director, Women’s Center, Sharp Memorial Hospital, San Diego, CA.

MSN,

Obstetrics and the Newborn is an illustrated textbook written by Professors of Obstetrics and Gynecology at the University of Melbourne and the University of Queensland, Australia. The book is divided into 12 parts and appendices which include sections on patient education, an overview of medical-legal problems, and questions and answers for students utilizing the textbook. The preface indicates the book’s intended use by both medical and nursing students. The book includes some of the traditional topics found in any text of obstetrics and the newborn, including: anatomy and physiology of the reproductive tract; normal findings in pregnancy, labor, and delivery; and, the postpartum period. This resource also presents a number of medical, surgical, and psychological disorders in pregnancy-such as cardiovascular problems, problems with the digestive and metabolic systems, and psychoses. In addition, there is a discussion about deviations from normal in the newborn. The authors should be commended for including psychosocial information with the physiological content. Tables, illustrations, and actual photographs of clinical obstetrical cases and newborn care are among the book’s greatest strengths. The tables and figures

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are well-dQcumented with captions, and th’e photographs are of the highest quality. Included are outstanding pictures of surgical techniques such as episiotomies and their repair, Cesarean section, vacuum extraction, and forceps application. Color photographs including those of abnormal neonatal findings such as meningomyelocele, skin disorders, cleft lip and palate, ambiguous genitalia, etc., are among the finest presentations of clinical photography this reviewer has seen. Thii book is an excellent resource for ,both medical and nursing students as well as clinical practitioners, including nurse-midwives. Fathers: There at the Birth. By Tim Spacek. Chicago: Chicago Review Press, 1985. 148 pages. $12.95, hardcover; $6.95, softcover. Reviewed by: Cornelia Handy, CPNP, Program Instructor, Yale University School of Nursing, New Haven, CT.

MSN,

Popularization of shared parental involvement in the childbirth process has increased interest in fathers’ views of preparation and participation. Author Tim Spacek initially became interested in writing thii book after the birth of his first son, and interviewed an unspecified number of men in order to explore their thoughts, feelings, and experiences associated with this special event. After choosing hi own and 11 other fathers’ accounts from taped interviews, he developed chapters describing their diverse, unique experiences in the births of their children. The resulting magnificent book captures and shares men’s courage, dedication, humor, hope, and anxieties. In a wonderful, moving style the author delineates the drama of human birth and relates paternal feelings. Several men share their fears and eager anticipation prior to parenthood. Others discuss the special closeness they felt with their spouse through pregnancy, labor, and delivery. Some of them describe openly the disappointment or physical/emotional drain that was prevalent in their experiences. Evidence of fathers’ fears and dreams, as well as their pride and elation, is vivid in each account. Equally apparent are the frank, honest descriptions of the fathers’ problems and suc-

Journal of Nurse-Midwifery

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cesses with home/hospital, single/twin births. For readers easily absorbed in the different accounts, the book may seem to end too quickly! It is doubtful, however, if additional reports would have added more breadth or substance to an already varied and rich sample of men and their children’s births. Such additions would have little enhanced the author’s already genuine achievement of communicating about participation in the birth process. The book’s major weakness is its apparent lack of a research database. For example, the author has included men from diverse cultures and lifestyles but neglects to state how they were chosen to be interviewed or where they came from. No mention is made of how many men were interviewed or how the interviews were selected out for use in the book. Additionally, no psychosocial or developmental theories are utilized to give the content a supportive framework. The only other shortcoming in the book is the absence of a general reading list. Couples would benefit from references offering greater detail concerning home birth, complications of birth, Lamaze teaching, or the LeBoyer method. Despite these few shortcomings, Fathers: There at the Birth is a relevant book for couples, awaiting the birth of a child, who may profit from reading it together. Any man, especially a first-time father, can gain from the knowledge, support, joy, and courage emanating from its pages. Although the book clearly is not intended for educational or professional use, midwives may find it a solid recommendation to couples seen in a variety of practice settings. Perhaps because it deals with such a key human experience, and because it uses lay language and real accounts from men with diverse backgrounds, this book is extremely effective in offering readers an understanding of the birth process. At the same time, it also comments on society’s view of birth, thereby touching one’s emotional core. Readers will look inward, reflect on their own feelings, and be better prepared for the adventure of their child’s birth. Maternal-Fetal Medicine. By Robert Creasy, MD, and Robert Resnick, MD. Philadelphia: W. B. Saunders Company, 1984. 1168 pages. $100.00, hardcover.

Vol. 32, No. 1, January/February 1987

Reviewed by: Jeanne Raisler, CNM,MPH, Assistant Professor, Nurse-Midwifery Program, State University of New York, Health Science Center at Brooklyn, NY. This textbook is rooted in the growing discipline of maternal-fetal medicine, or pennatology. The intention of the editors was not to create another basic obstetrics textbook, but rather to “develop a reference source that would go a step beyond the basics.” The book features 27 chapters by 47 contributors, many of whom are physician researchers and faculty members of the University of California schools of medicine. Many authors are recognized authorities in their topics. The content is described by the editors as being “current, and at the leading edge of maternal-fetal medicine.” What differentiates a textbook of matemal-fetal medicine from a textbook of obstetrics? In this case, a strong emphasis on basic science research is combined with, and often dominates, the clinical orientation usually found in an obstetrics textbook. Chapters concentrate heavily on investigating the physiological basis of normal and abnormal reproduction. Sections devoted to patient management, by contrast, are often brief. The book is divided into four sections. The first four chapters-approximately 200 pages-discuss early fetal development and the environment. This section includes two extensive chapters on reproductive genetics and congenital disorders. Also included are reviews of the gestational changes of pregnancy, the puerperium, and the hormonal/physiological basis of lactation. The section concludes with a practical and wellwritten chapter on maternal nutrition, and another on the effects of chemical and environmental agents on pregnancy. Section II, 173 pages, considers diagnostic modalities in maternal-fetal medicine, as well as their underlying physiological basis. Noteworthy here are comprehensive chapters on ultrasound, biophysical evaluation of fetal status, and the endocrinology of pregnancy. Section III, “Maternal and Fetal Pathophysiology,” is the heart of the book, comprising over 700 pages. Outstanding in this section are lengthy chapters on preterm labor, maternal blood group immunization, maternal-fetal infections, cardiovascular and renal disorders, hematologic disorders, and diabetic preg-

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