- Email: [email protected]
Rx for a liberated childbirth
could be useful as a teaching pamphlet, or to provide reassurance to new mothers that others experience similar feelings. The concepts of “mothering oneself’ and mobilizing social support systems are valuable ones. For the nurse reader, the fact that a comparable professional publication is not available is a painful reminder of literay inertia within the profession. A pamphlet or book written from nursing’s scientific perspective on the topic of postpartum disturbance would be a welcome and timely project.
Living with Your New Baby: A Postpartum Guide for Mothers and Fathers. By Elly Rakowitz and Gloria Rubin. New York: Franklin Watts, Inc., 1978. $8.95. Reviewed by: Rosalind Kendellen, C.N.M., Clinical Assistant Professor, Nurse-Midwifery Program, Downstate Medical Center. Despite all the emphasis in the mass market paperback trade on preparation of prospective parents for childbirth, breast-feeding, and parenting, the normal developmental crisis of the early postpartum period has, to date, been given little specific attention.’ Here is a book, Living With Your New Baby: A Postpartum Guide for Mothers and Fathers that
competently guides parents going through the first three tumultuous months after birth. As the authors note at the outset, the book is directed toward middle class women having a traditional hospital birth. Both authors have some background experience for writing on the subject from their active involvement in childbirth organizations and from being mothers themselves. The book is warm, clearly written, and easily readable. The authors have done a remarkable job of organizing their material and emphasizing the right subjects. There are three main chapter headings: Preparing for Postpartum, After the Birth,
’An exception is a small paperback book, What Now? written in 1972 by Mary Lou Rodilsky and Barbara &net, which, although limited in scope, presents mrne valuable information.
38
and Practical Problems and Solutions; subtopics are discussed under the main headings. Within these chapters are several types of material. For example, there are detailed accounts of the involutional changes that occur in the mother’s body during the first six weeks, hospital procedures involving the mother and baby beginning with the third stage of labor, a physical assessment of the newborn, and a welcome thirty page section on postcesarean delivery. The topic of infant feeding is wisely limited and the authors refer the reader to breast-feeding texts. The most helpful material by far is the description of changes in feelings, role, self-image, life-style, and relationships that occur after a normal delivey, a cesarean delivery, and after a tragedy. While most of the discussion is directed toward the mother, the father is also included. In addition, special situations involving the single mother, the working mother, and the mother having a second child are given deserved attention. The authors impart a sense of relief and normalcy to new parents by honestly discussing the situations in which they find themselves and by including narrative comments from couples who have recently become new parents. Also valuable is the practical, encouraging advice and suggestions offered on dealing with these changes. For example, the authors devote several pages to concrete suggestions on how to minimize the postpartum baby blues, a specific one being to set up parent rap groups. The authors have successfully done this and provide information on initiating and maintaining the group. Also, important advice is offered to the mother on the problem of wisely budgeting curtailed time, how to handle the crying baby, traveling with a new baby, finances, and selecting a contraceptive. However, additional information could have been included on the adolescent mother, mother with a previous disappointing experience, the mother coming home to several children, couples choosing alternative birthing styles, reestablishing sexual relations, as well as on how to cope assertively and intelligently within the medical care system. All these are pertinent issues. This hardcover book is expensively priced at $8.95. The print is small, unexciting, and the text is lacking in graphics.
Rx for a Liberated Childbirth. By Bev Smucha and Alice Unger. New York: Ashley Books, Inc., 1978. 160 pages. $8.95. Reviewed by: Elizabeth Vitale, C.N.M., Staff Nurse-Midwife, Community Health Services, Hartford, Connecticut. The goal of this book is to dispel the myths surrounding pregnancy, and to provide pregnant women with a feeling of sisterhood with other pregnant women through reassuring them that many share their emotional experiences. The two authors draw from their persona1 experiences and those of other women, In addition, they offer advice and information on both medical and psychological issues. A strong motivating force in the inception of this book appears to be the authors’ anger prompted by their contention that most of the literature on pregnancy and childbirth was written by men. They profess that male authors cannot offer the understanding and compassion that other women can. Unfortunately, thii sets the tone for the book, and results in outdated statements and factual inaccuracies. In approaching the book both as a I nurse-midwife and as a consumer, found myself concerned with the authors’ apparent unfamiliarity with current trends and literature on pregnancy and childbirth, information which has been widely available to the public. For example, Chapter 7, entitled “Your Doctor’s Function” includes a brief discussion on finding a doctor. Nurse-midwives are not mentioned at all as an option for care. While there is a fairly detailed discussion of what to expect of prenatal care in terms of the physical examination and laboratory tests, attention to the emotional aspects of prenatal care is conspicuous by its absence. Another example is found in the discussion of cesarean delivey: “Since a cesarean is a surgical procedure, your partner will not be admitted to the surgey suite” (p. 99). This is misleading, since an increasing number of hospitals are welcoming partners for cesarean births. On the other hand, the authors succeed in their presentation of some aspects of labor and delivey. Their inclusion of some definitions of medical jargon is quite useful. In addition, the authors em-
Journal of Nurse-Midwifery
?? Vol.
25, No. 2. March/April 1980
phasize the unique nature of each labor and delivery experience, and caution women against setting up unrealistic expectations, which may leave them with a feeling of failure. However, once again, there is no mention of the partner’s role in labor and delivery, nor of comfort measures other than medication. Unfortunately, the discussion of rooming-in is, once again, simplistic and outdated. Their summaries such as “You have the rest of your life to care for your child, therefore, if you’re not up to it, we do not advise rooming-in” (p. 145), tend to be misleading. Moreover, this attitude in itself disregards the current! theories on “bonding,” a topic that deserves some mention in any discussion of the early postpartum period. The section on breast-feeding seems to reflect a strong bias against breastfeeding. Four-and-a-half pages introduce the subject with negative images. The sacrifices a nursing mother must make are enumerated in great detail: “. lack of sleep . milk leakage, pain and discomfort, more of a commitment to the baby, not having the freedom of dress, having to eat more, and lack of freedom. It’s a feeling almost like you’re still pregnant; your body still does not belong totally to you” (p. 130). And further: “There is a natural beauty in breastfeeding, but what they don’t tell us is that you walk around sometimes feeling somewhat like a ‘Lcow,” undressing and dressing, often forgetting to put yourself together” (p. 134). This tirade is followed by only a brief paragraph entitled “The Positive Side,” which stresses only the physical and economic benefits, but ignores all of the emotionally satisfying aspects of nursing. Subsequently, there is a section on “Problems in Breast-feeding,” the negativity persisting throughout. Medical advice and information in this book also is often simplistic, inaccurate, and misleading. For example, the reader is informed that “strong pressures” in the abdomen, legs, back, and groin are due to the stretching of abdominal skin and the weight of the baby and fluid; that massage creams or cocoa butter will prevent stretch marks; that shortness of breath on the slightest exertion is normal in the third trimester; that cesareans are performed only when birth through the birth canal is impossible; ,that in a home birth there is no way to monitor the baby’s heartbeat during labor; that after
Journal of Nurse-Midwifery
the initial pelvic examination, a woman will not normally have a pelvic examination until the onset of labor. The section on “Rest and Activity” emphasizes rest during pregnancy without discussing the benefits of exercise. One would be welladvised not to use this book for medical information. The book does, however, offer other information that is quite useful. The discussion of the legal rights of pregnant women in relation to employment is both useful and timely. Also, the section on day care and cooperatives, which offers a number of ideas for new mothers to help one another during the early postpartum period, is worthwhile. Finally, one creative touch in the book is the inclusion of a blank page at the end of each chapter with the heading “My Thoughts Itemized.” This encourages the reader to reflect on her own thoughts and to record them. There is, unfortunately, ultimately little information in Rx for a Liberated Childbirth that is not covered in other publications in a much more thorough, accurate, updated, and enlightened way. With due respect to the authors and the compassion and feelings of sisterhood inherent in their work, there is little in this book to recommend it to either professionals or consumers. A lesson we may draw from this book is that, regardless of how poignant and valid our personal experiences and feelings may be, we must be wary of generalizing them into advice and teachings for consumers.
ment, and preventive techniques, i.e., washing, condoms, and germicidal preparations. The content is clear, precise, and well-organized with an emphasis on prevention and education. This constructive emphasis is often lacking in other venereal disease publications, which primarily focus on the person after she/he has become infected. Depth of information is sacrificed for breadth of content, probably due to space limitations. For example, psychosexual ramifications of the preventive suggestions are not discussed. Certain references to venereal disease transmission via oral and anal routes may deter some couples from engaging in alternatives to vaginal intercourse. Technically, lay out and design are adequate. Illustrations are absent. Readability should be assessed on an individual basis. Medical and anatomical terms will be problematical for many readers. Since dissemination and comprehension of this information is vitally important, hopefully, the American Foundation for the Prevention of Venereal Disease will consider developing several versions of the publication, including in-depth discussions of some of the topics.
The First Gifts. By Grace L. Berg, C.N.M. First Edition printed by the New Jersey State Department of Health; Revised Edition printed by the Caring Mother’s Cooperative, Box 211, Tuckerton, New Jersey 08087, 1978. 68 pages. Price: To be established. Reviewed
The New Venereal Disease Prevention for Everyone. Sixth Edition. New York:
American Foundation for the Prevention of Venereal Disease, Inc., 1978. 12 pages Reviewed
by:
Mary-Scovill
Elder,
C.N.M., M.S. Cost: Free Available from: American Foundation for the Prevention of Venereal Disease, Inc., 93 Worth Street, New York, New York 10013 Description: This pamphlet includes abbreviated information on the signs and dangers of syphilis and gonorrhea, brief descriptions of thirteen other sexually transmitted diseases, examination, treat-
a Vol. 25. No. 2, March/April
1980
by: Betty Watts Canington, C.N.M., MS., Nurse-Midwifery Educational Program, College of Health Related Professions, Downstate Medical Center.
The First Gifk; is a delightfully comprehensive educational booklet designed especially for pregnant adolescents. Strengths of this work are its excellent illustrations, organization, and clarity. The language is basic, straightforward, and easily understandable. Analogies are those that are familiar to the target population’s experience. An example of this occurs during a discussion on the reason for “shortness of breath” commonly experienced by pregnant women from the eighth to tenth lunar months. Increased
39
Living with Your New Baby: A Postpartum Guide for Mothers and Fathers. By Elly Rakowitz and Gloria Rubin. New York: Franklin Watts, Inc., 1978. $8.95. Reviewed by: Rosalind Kendellen, C.N.M., Clinical Assistant Professor, Nurse-Midwifery Program, Downstate Medical Center. Despite all the emphasis in the mass market paperback trade on preparation of prospective parents for childbirth, breast-feeding, and parenting, the normal developmental crisis of the early postpartum period has, to date, been given little specific attention.’ Here is a book, Living With Your New Baby: A Postpartum Guide for Mothers and Fathers that
competently guides parents going through the first three tumultuous months after birth. As the authors note at the outset, the book is directed toward middle class women having a traditional hospital birth. Both authors have some background experience for writing on the subject from their active involvement in childbirth organizations and from being mothers themselves. The book is warm, clearly written, and easily readable. The authors have done a remarkable job of organizing their material and emphasizing the right subjects. There are three main chapter headings: Preparing for Postpartum, After the Birth,
’An exception is a small paperback book, What Now? written in 1972 by Mary Lou Rodilsky and Barbara &net, which, although limited in scope, presents mrne valuable information.
38
and Practical Problems and Solutions; subtopics are discussed under the main headings. Within these chapters are several types of material. For example, there are detailed accounts of the involutional changes that occur in the mother’s body during the first six weeks, hospital procedures involving the mother and baby beginning with the third stage of labor, a physical assessment of the newborn, and a welcome thirty page section on postcesarean delivery. The topic of infant feeding is wisely limited and the authors refer the reader to breast-feeding texts. The most helpful material by far is the description of changes in feelings, role, self-image, life-style, and relationships that occur after a normal delivey, a cesarean delivery, and after a tragedy. While most of the discussion is directed toward the mother, the father is also included. In addition, special situations involving the single mother, the working mother, and the mother having a second child are given deserved attention. The authors impart a sense of relief and normalcy to new parents by honestly discussing the situations in which they find themselves and by including narrative comments from couples who have recently become new parents. Also valuable is the practical, encouraging advice and suggestions offered on dealing with these changes. For example, the authors devote several pages to concrete suggestions on how to minimize the postpartum baby blues, a specific one being to set up parent rap groups. The authors have successfully done this and provide information on initiating and maintaining the group. Also, important advice is offered to the mother on the problem of wisely budgeting curtailed time, how to handle the crying baby, traveling with a new baby, finances, and selecting a contraceptive. However, additional information could have been included on the adolescent mother, mother with a previous disappointing experience, the mother coming home to several children, couples choosing alternative birthing styles, reestablishing sexual relations, as well as on how to cope assertively and intelligently within the medical care system. All these are pertinent issues. This hardcover book is expensively priced at $8.95. The print is small, unexciting, and the text is lacking in graphics.
Rx for a Liberated Childbirth. By Bev Smucha and Alice Unger. New York: Ashley Books, Inc., 1978. 160 pages. $8.95. Reviewed by: Elizabeth Vitale, C.N.M., Staff Nurse-Midwife, Community Health Services, Hartford, Connecticut. The goal of this book is to dispel the myths surrounding pregnancy, and to provide pregnant women with a feeling of sisterhood with other pregnant women through reassuring them that many share their emotional experiences. The two authors draw from their persona1 experiences and those of other women, In addition, they offer advice and information on both medical and psychological issues. A strong motivating force in the inception of this book appears to be the authors’ anger prompted by their contention that most of the literature on pregnancy and childbirth was written by men. They profess that male authors cannot offer the understanding and compassion that other women can. Unfortunately, thii sets the tone for the book, and results in outdated statements and factual inaccuracies. In approaching the book both as a I nurse-midwife and as a consumer, found myself concerned with the authors’ apparent unfamiliarity with current trends and literature on pregnancy and childbirth, information which has been widely available to the public. For example, Chapter 7, entitled “Your Doctor’s Function” includes a brief discussion on finding a doctor. Nurse-midwives are not mentioned at all as an option for care. While there is a fairly detailed discussion of what to expect of prenatal care in terms of the physical examination and laboratory tests, attention to the emotional aspects of prenatal care is conspicuous by its absence. Another example is found in the discussion of cesarean delivey: “Since a cesarean is a surgical procedure, your partner will not be admitted to the surgey suite” (p. 99). This is misleading, since an increasing number of hospitals are welcoming partners for cesarean births. On the other hand, the authors succeed in their presentation of some aspects of labor and delivey. Their inclusion of some definitions of medical jargon is quite useful. In addition, the authors em-
Journal of Nurse-Midwifery
?? Vol.
25, No. 2. March/April 1980
phasize the unique nature of each labor and delivery experience, and caution women against setting up unrealistic expectations, which may leave them with a feeling of failure. However, once again, there is no mention of the partner’s role in labor and delivery, nor of comfort measures other than medication. Unfortunately, the discussion of rooming-in is, once again, simplistic and outdated. Their summaries such as “You have the rest of your life to care for your child, therefore, if you’re not up to it, we do not advise rooming-in” (p. 145), tend to be misleading. Moreover, this attitude in itself disregards the current! theories on “bonding,” a topic that deserves some mention in any discussion of the early postpartum period. The section on breast-feeding seems to reflect a strong bias against breastfeeding. Four-and-a-half pages introduce the subject with negative images. The sacrifices a nursing mother must make are enumerated in great detail: “. lack of sleep . milk leakage, pain and discomfort, more of a commitment to the baby, not having the freedom of dress, having to eat more, and lack of freedom. It’s a feeling almost like you’re still pregnant; your body still does not belong totally to you” (p. 130). And further: “There is a natural beauty in breastfeeding, but what they don’t tell us is that you walk around sometimes feeling somewhat like a ‘Lcow,” undressing and dressing, often forgetting to put yourself together” (p. 134). This tirade is followed by only a brief paragraph entitled “The Positive Side,” which stresses only the physical and economic benefits, but ignores all of the emotionally satisfying aspects of nursing. Subsequently, there is a section on “Problems in Breast-feeding,” the negativity persisting throughout. Medical advice and information in this book also is often simplistic, inaccurate, and misleading. For example, the reader is informed that “strong pressures” in the abdomen, legs, back, and groin are due to the stretching of abdominal skin and the weight of the baby and fluid; that massage creams or cocoa butter will prevent stretch marks; that shortness of breath on the slightest exertion is normal in the third trimester; that cesareans are performed only when birth through the birth canal is impossible; ,that in a home birth there is no way to monitor the baby’s heartbeat during labor; that after
Journal of Nurse-Midwifery
the initial pelvic examination, a woman will not normally have a pelvic examination until the onset of labor. The section on “Rest and Activity” emphasizes rest during pregnancy without discussing the benefits of exercise. One would be welladvised not to use this book for medical information. The book does, however, offer other information that is quite useful. The discussion of the legal rights of pregnant women in relation to employment is both useful and timely. Also, the section on day care and cooperatives, which offers a number of ideas for new mothers to help one another during the early postpartum period, is worthwhile. Finally, one creative touch in the book is the inclusion of a blank page at the end of each chapter with the heading “My Thoughts Itemized.” This encourages the reader to reflect on her own thoughts and to record them. There is, unfortunately, ultimately little information in Rx for a Liberated Childbirth that is not covered in other publications in a much more thorough, accurate, updated, and enlightened way. With due respect to the authors and the compassion and feelings of sisterhood inherent in their work, there is little in this book to recommend it to either professionals or consumers. A lesson we may draw from this book is that, regardless of how poignant and valid our personal experiences and feelings may be, we must be wary of generalizing them into advice and teachings for consumers.
ment, and preventive techniques, i.e., washing, condoms, and germicidal preparations. The content is clear, precise, and well-organized with an emphasis on prevention and education. This constructive emphasis is often lacking in other venereal disease publications, which primarily focus on the person after she/he has become infected. Depth of information is sacrificed for breadth of content, probably due to space limitations. For example, psychosexual ramifications of the preventive suggestions are not discussed. Certain references to venereal disease transmission via oral and anal routes may deter some couples from engaging in alternatives to vaginal intercourse. Technically, lay out and design are adequate. Illustrations are absent. Readability should be assessed on an individual basis. Medical and anatomical terms will be problematical for many readers. Since dissemination and comprehension of this information is vitally important, hopefully, the American Foundation for the Prevention of Venereal Disease will consider developing several versions of the publication, including in-depth discussions of some of the topics.
The First Gifts. By Grace L. Berg, C.N.M. First Edition printed by the New Jersey State Department of Health; Revised Edition printed by the Caring Mother’s Cooperative, Box 211, Tuckerton, New Jersey 08087, 1978. 68 pages. Price: To be established. Reviewed
The New Venereal Disease Prevention for Everyone. Sixth Edition. New York:
American Foundation for the Prevention of Venereal Disease, Inc., 1978. 12 pages Reviewed
by:
Mary-Scovill
Elder,
C.N.M., M.S. Cost: Free Available from: American Foundation for the Prevention of Venereal Disease, Inc., 93 Worth Street, New York, New York 10013 Description: This pamphlet includes abbreviated information on the signs and dangers of syphilis and gonorrhea, brief descriptions of thirteen other sexually transmitted diseases, examination, treat-
a Vol. 25. No. 2, March/April
1980
by: Betty Watts Canington, C.N.M., MS., Nurse-Midwifery Educational Program, College of Health Related Professions, Downstate Medical Center.
The First Gifk; is a delightfully comprehensive educational booklet designed especially for pregnant adolescents. Strengths of this work are its excellent illustrations, organization, and clarity. The language is basic, straightforward, and easily understandable. Analogies are those that are familiar to the target population’s experience. An example of this occurs during a discussion on the reason for “shortness of breath” commonly experienced by pregnant women from the eighth to tenth lunar months. Increased
39