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The complete pregnancy workbook: A guide for parents-to-be
Department of Obstetrics and Gynecology, and Lecturer, Graduate NurseMidwifey Program, University of Colorado Health Sciences Center, Denver, Colorado. Contraception and Chronic Illnesses: A Clinician’s Sourcebook reviews and synthesizes research and clinical anecdotes related to contraceptive methods for people with chronic illnesses such as diabetes, cardiac disease, and cancer. It was originally published as a special series in the Contraceptive Technology Update monthly newsletter. The physician authors have backgrounds in pediatrics and medicine. The material is presented clearly and concisely, basically summarizing reviews of the literature. Chapters, each of which cover different disease groups, average about 21 references, but are only about five pages in length. The reader can easily complete the book in an evening. It may then be used as a resource to refer to in the clinical setting. Some chapters include succinct lists of findings to guide the clinician. There is an index but there are only two charts and no illustrations. The contraceptive methods that receive the greatest attention are, first, oral contraceptives and, second, intrauterine devices. Some information will be familiar to family planning care providers. For example, many contraindications to OC or IUD use are the same as those for nonchronically ill patients, such as hypertension for OCs or sexual promiscuity (multiple partners) for the IUD. It is noted in the introduction that “generally, barrier methods . . . do not complicate chronic illnesses”: they are mentioned only briefly and occasionally in the text. Other methods, such as natural family planning, coitus interruptus, and sexual expression without intercourse, receive no mention. Nurse-midwives working in settings with a significant responsibility for collaborative or high risk management will find the book useful. An additional strength of the book is the frequent inclusion of information on the impact of pregnancy upon specific chronic diseases. This information highlights the importance of contraception in populations that can be seriously threatened by undesired or unplanned pregnancies. In the final chapter, the point is made that “too often, clinicians ignore those [chronically ill] patients’ sexuality, or consider it as 150
problem number 20 on a list of 20 problems.” Nurse-midwives can play a valuable role by counseling chronically ill patients on their sexual practices and contraceptive methods. The numerous references supporting the chapters include English and nonEnglish language journals. However, the referehces are predominantly from the 1960s and 1970s. For instance, Chapter 3 on neurological problems contains one reference from the current decade out of a total of 37 citations. Despite, or perhaps because of the variety of references, many gray areas remain in the conclusions drawn by the authors as to which method is best for a woman with a particular chronic illness due to the following reasons: no research data is available on the subject, the published research studies conflict with each other, research indicates a trend but not significantly, or the information is anecdotal and includes small numbers of affected individuals. The book could be a useful guide for providers closely involved with the care of chronically ill women. But the high price of the book ($24.95) in comparison to its length (96 pages) and the rather abbreviated amount of specific information about contraception and chronic illness, all limit the book’s usefulness for CNMs who care for well women.
The Complete Pregnancy Workbook: A Guide for Parents-To-Be. By Philip Sloane, Salli Benedict, and Melanie Mintzer. Chapel Hill, NC: Algonquin Books, 1986. 268 pages. $13.95, softcover. Reviewed by: Peggy Visher, CNM, MSN, Private Practice, Brooklyn, NY. The Complete Pregnancy Workbook is a thorough, well written book about pregnancy, childbirth, and the postpartum period. It is written for parents who wish to make informed decisions regarding their pregnancy. Though it is geared toward the parent who is completely uninformed about childbirth, it provides enough detail to allow parents to make educated choices throughout their pregnancy. The authors are well qualified to write this book. Dr. Sloane and Dr. Mintzer are both family practice doctors at the North Carolina Memorial Hospital at the University of North Carolina in Chapel Hill,
N.C. Ms. Benedict is a health educator and the mother of two children. Dr. Sloane is the father of two children. The book was developed by interviewing women during pregnancy and the postpartum period to determine what information they would like to learn from a book about childbirth. A workbook was printed for use by patients in the authors’ practices. Before revising the book for a wider audience, a series of interviews were conducted with the women who had used the book. Revisions were made based on their comments. Since the book was written using parents as such active participants, it covers the majority of questions asked throughout a pregnancy. The topics in the book are organized according to when they are usually discussed during pregnancy. The first several chapters help the couple with many of their initial questions about deciding to have a baby, preparing for a healthy pregnancy, conceiving, and choosing a health care provider. There are about 20 worksheets in the back of the book that assist the parents-to-be in choosing among various options. At the end of every chapter, there is also a list of recommended readings. The topics covered in the first few chapters are important health issues that the couple should be aware of before starting a pregnancy. These subjects include genetic counselling, the Rh factor, genital herpes, occupational hazards, environmental risks, dangerous drugs, rubella, toxoplasmosis, and current medical problems. Various types of health care (from obstetricians to lay midwives) and delivery options (from hospital to home birth) are dealt with in an informative manner. The language used throughout the book is appropriate for consumers receiving prenatal care from the different types of available health care providers. The chapters on pregnancy continue to cover relevant questions and provide practical advice. The chapter on nutrition is thorough and accurate, as is the chapter on exercise during pregnancy. A fitness program, with diagrams of the exercises, is presented in an easy to follow manner. A chapter on working in pregnancy has charts with suggestions for making the combination of work and pregnancy easier. Legal rights, as well as occupational risks, are also covered. There is an excellent chart of exposure to
Journal of Nurse-Midwifery
??Vol.
33, No. 3, May/June 1988
different substances and the occupations most likely to be at risk. The chapter on miscarriage provides good, practical advice about the high percentage of miscarriages in the first trimester, possible causes, and the couples’ chances of conceiving again. Another section which has a rational approach is the use of medication during pregnancy. Various drugs are covered and the benefits and risks are evaluated. The authors do not take the position that all drugs used during pregnancy are harmful and feel many drugs may be used judiciously and effectively to help the mother. Physical and emotional changes (for
Journal of Nurse-Midwifery
??Vol.
both the mother and father) are covered well in the book. Sexual relations as well as new responsibilities, pressures, and joys are dealt with in an open and thorough manner. The book is realistic about the difficulties of caring for a newborn and going through the physical changes of the postpartum period. Practical suggestions are made concerning the importance of accepting help from friends and family, having realistic expectations for the amount one can accomplish, and the continuing need to nurture the relationship between the couple. There are several omissions of tests often conducted during the prenatal pe-
33, No. 3, May/June
1988
riod. The information on available urine pregnancy tests is outdated. There is no discussion of the glucose challenge test, the glucose tolerance test, or the two hour postprandial. There is also no discussion of the use of nipple stimulation in the conduction of a contraction stress test (although the OCT is discussed). Overall, The Complete Pregnancy Workbook is an excellent book for both expecting parents. They will find the book easy to read and to understand, and at the same time extremely thorough and accurate.
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problem number 20 on a list of 20 problems.” Nurse-midwives can play a valuable role by counseling chronically ill patients on their sexual practices and contraceptive methods. The numerous references supporting the chapters include English and nonEnglish language journals. However, the referehces are predominantly from the 1960s and 1970s. For instance, Chapter 3 on neurological problems contains one reference from the current decade out of a total of 37 citations. Despite, or perhaps because of the variety of references, many gray areas remain in the conclusions drawn by the authors as to which method is best for a woman with a particular chronic illness due to the following reasons: no research data is available on the subject, the published research studies conflict with each other, research indicates a trend but not significantly, or the information is anecdotal and includes small numbers of affected individuals. The book could be a useful guide for providers closely involved with the care of chronically ill women. But the high price of the book ($24.95) in comparison to its length (96 pages) and the rather abbreviated amount of specific information about contraception and chronic illness, all limit the book’s usefulness for CNMs who care for well women.
The Complete Pregnancy Workbook: A Guide for Parents-To-Be. By Philip Sloane, Salli Benedict, and Melanie Mintzer. Chapel Hill, NC: Algonquin Books, 1986. 268 pages. $13.95, softcover. Reviewed by: Peggy Visher, CNM, MSN, Private Practice, Brooklyn, NY. The Complete Pregnancy Workbook is a thorough, well written book about pregnancy, childbirth, and the postpartum period. It is written for parents who wish to make informed decisions regarding their pregnancy. Though it is geared toward the parent who is completely uninformed about childbirth, it provides enough detail to allow parents to make educated choices throughout their pregnancy. The authors are well qualified to write this book. Dr. Sloane and Dr. Mintzer are both family practice doctors at the North Carolina Memorial Hospital at the University of North Carolina in Chapel Hill,
N.C. Ms. Benedict is a health educator and the mother of two children. Dr. Sloane is the father of two children. The book was developed by interviewing women during pregnancy and the postpartum period to determine what information they would like to learn from a book about childbirth. A workbook was printed for use by patients in the authors’ practices. Before revising the book for a wider audience, a series of interviews were conducted with the women who had used the book. Revisions were made based on their comments. Since the book was written using parents as such active participants, it covers the majority of questions asked throughout a pregnancy. The topics in the book are organized according to when they are usually discussed during pregnancy. The first several chapters help the couple with many of their initial questions about deciding to have a baby, preparing for a healthy pregnancy, conceiving, and choosing a health care provider. There are about 20 worksheets in the back of the book that assist the parents-to-be in choosing among various options. At the end of every chapter, there is also a list of recommended readings. The topics covered in the first few chapters are important health issues that the couple should be aware of before starting a pregnancy. These subjects include genetic counselling, the Rh factor, genital herpes, occupational hazards, environmental risks, dangerous drugs, rubella, toxoplasmosis, and current medical problems. Various types of health care (from obstetricians to lay midwives) and delivery options (from hospital to home birth) are dealt with in an informative manner. The language used throughout the book is appropriate for consumers receiving prenatal care from the different types of available health care providers. The chapters on pregnancy continue to cover relevant questions and provide practical advice. The chapter on nutrition is thorough and accurate, as is the chapter on exercise during pregnancy. A fitness program, with diagrams of the exercises, is presented in an easy to follow manner. A chapter on working in pregnancy has charts with suggestions for making the combination of work and pregnancy easier. Legal rights, as well as occupational risks, are also covered. There is an excellent chart of exposure to
Journal of Nurse-Midwifery
??Vol.
33, No. 3, May/June 1988
different substances and the occupations most likely to be at risk. The chapter on miscarriage provides good, practical advice about the high percentage of miscarriages in the first trimester, possible causes, and the couples’ chances of conceiving again. Another section which has a rational approach is the use of medication during pregnancy. Various drugs are covered and the benefits and risks are evaluated. The authors do not take the position that all drugs used during pregnancy are harmful and feel many drugs may be used judiciously and effectively to help the mother. Physical and emotional changes (for
Journal of Nurse-Midwifery
??Vol.
both the mother and father) are covered well in the book. Sexual relations as well as new responsibilities, pressures, and joys are dealt with in an open and thorough manner. The book is realistic about the difficulties of caring for a newborn and going through the physical changes of the postpartum period. Practical suggestions are made concerning the importance of accepting help from friends and family, having realistic expectations for the amount one can accomplish, and the continuing need to nurture the relationship between the couple. There are several omissions of tests often conducted during the prenatal pe-
33, No. 3, May/June
1988
riod. The information on available urine pregnancy tests is outdated. There is no discussion of the glucose challenge test, the glucose tolerance test, or the two hour postprandial. There is also no discussion of the use of nipple stimulation in the conduction of a contraction stress test (although the OCT is discussed). Overall, The Complete Pregnancy Workbook is an excellent book for both expecting parents. They will find the book easy to read and to understand, and at the same time extremely thorough and accurate.
151