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What If I Have a C-Section?
MEDIA REVIEW What If I Have a C-Section? By Rita Rubin. New York, NY: Rodale, 2004. 206 pages. $12.95, paperback. Reviewed by: Audrey J. Perry, CNM, MSN, Regional Clinical Coordinator, Frontier School of Midwifery and Family Nursing, Lancaster, PA. In 2002, 261 of every 1000 babies born in the United States entered the world via cesarean birth. Most of these mothers were planning on a vaginal birth. According to Rita Rubin, the author of What If I Have a C-Section?, one of the biggest complaints women have is feeling unprepared for a cesarean outcome. The author professes in her introduction that “knowledge is power.” What If I Have a C-Section? equips mothers-to-be with the knowledge necessary to be empowered in an unplanned or planned cesarean birth. The book is divided into 2 parts, “The Complete C-section Guide” and “Making the Decision: Yes or No?” The initial presentation of common causes of cesarean birth, what happens the day of the cesarean, and issues related to recovery provides a knowledge base for a reader. The second half of the book addresses the choice of cesarean birth. The organization of the text is logical. The reader is able to better address the decision and debates surrounding cesarean birth. Controversial issues of vaginal birth after cesarean (VBAC), neonatal outcomes via cesarean, and cesarean-ondemand are addressed objectively. Myths are deconstructed with the presentation of relevant recent research. The bibliography is both current and extensive. One glaring omission in the book and bibliography relates to higher VBAC success rates and lower rates of primary cesarean birth with certified nurse-midwives compared with physicians. Rubin’s suggestions for decreasing the reader’s chance of cesarean birth is otherwise thorough and supported by current research; however, a discussion of midwifery care would complement a revised edition.
Journal of Midwifery & Women’s Health • www.jmwh.org © 2005 by the American College of Nurse-Midwives Issued by Elsevier Inc.
Rubin’s presentation of current clinical research peppered with individual women’s birth stories keeps the intended audience engaged. For the general public, the complex medical research surrounding cesarean birth is clarified by suggested “talking points.” The “talking point” is a suggestion or question designed to empower and assist the reader in navigating the health care system. In addition, “words from the wise” contained in each chapter is a collection of suggestions from experienced parents and practitioners. Rubin further held this reviewer’s attention by including historical perspectives on cesarean birth in her “looking back” side bars. The text entertains and informs the reader. The presentation of personal opinion and experiences engages the reader; however, the objectivity of the material is occasionally lost. Rubin asserts in her forward that it is her intent to empower the reader. During her presentation of tips to avoid a cesarean, Rubin discourages detailed birth plans. The author’s assertion to keep birth plans short is not supported by research, but a personal opinion. In this reviewer’s opinion, the author contradicts her stated purpose of empowerment by suggesting women not detail a birth plan, a tool that projects women’s voices and wishes. In this reviewer’s opinion, the methods of childbirth preparation in the United States have not adequately addressed the rising trend of cesarean birth. As noted above, the cesarean birth rate in the United States is at an all time high. The majority of families experiencing cesarean birth intended a vaginal delivery. The bulk of childbirth preparation focuses on coping with labor with little or no discussion of the events surrounding cesarean. With so many women birthing via cesarean, it is our obligation to educate and inform people about this experience. Rubin’s book is an excellent tool for practitioners to use in addressing the nationwide knowledge deficit related to childbirth and cesarean birth preparation.
e63 1526-9523/05/$30.00
Journal of Midwifery & Women’s Health • www.jmwh.org © 2005 by the American College of Nurse-Midwives Issued by Elsevier Inc.
Rubin’s presentation of current clinical research peppered with individual women’s birth stories keeps the intended audience engaged. For the general public, the complex medical research surrounding cesarean birth is clarified by suggested “talking points.” The “talking point” is a suggestion or question designed to empower and assist the reader in navigating the health care system. In addition, “words from the wise” contained in each chapter is a collection of suggestions from experienced parents and practitioners. Rubin further held this reviewer’s attention by including historical perspectives on cesarean birth in her “looking back” side bars. The text entertains and informs the reader. The presentation of personal opinion and experiences engages the reader; however, the objectivity of the material is occasionally lost. Rubin asserts in her forward that it is her intent to empower the reader. During her presentation of tips to avoid a cesarean, Rubin discourages detailed birth plans. The author’s assertion to keep birth plans short is not supported by research, but a personal opinion. In this reviewer’s opinion, the author contradicts her stated purpose of empowerment by suggesting women not detail a birth plan, a tool that projects women’s voices and wishes. In this reviewer’s opinion, the methods of childbirth preparation in the United States have not adequately addressed the rising trend of cesarean birth. As noted above, the cesarean birth rate in the United States is at an all time high. The majority of families experiencing cesarean birth intended a vaginal delivery. The bulk of childbirth preparation focuses on coping with labor with little or no discussion of the events surrounding cesarean. With so many women birthing via cesarean, it is our obligation to educate and inform people about this experience. Rubin’s book is an excellent tool for practitioners to use in addressing the nationwide knowledge deficit related to childbirth and cesarean birth preparation.
e63 1526-9523/05/$30.00