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Book Review

One step that pregnant women can take towards making sure their care provider is familiar with the latest evidence-based maternity practices is to give their doctor or midwife a copy of the book “Optimal Care in Childbirth,” by Henci Goer and Amy Romano.  Every maternity care provider should read this book, and keep it handy as a reference.  Women might want to keep a copy for themselves too.  Giving this book to your doctor or midwife sends a strong message that you value and expect to receive evidence-based maternity care and that you are savvy enough and motivated enough to seek out the evidence basis of their practice.

This book is not an easy read, nor is it intended as a reference for expectant women.  Instead of “what to expect…” this book is full of detailed scientific evidence about the care birthing women should be given and uses the physiologic, or the normal natural physical process of birth as the basis of care.  Authored by a medical writer and acknowledged expert in evidence-based maternity care and a research expert/midwife, “Optimal Care in Childbirth” gives thorough analyses of current medical maternity practices and the evidence that supports or refutes their use.  It also provides strategies for optimal care and mini-reviews of the evidence, and leaves no stone unturned with respect to the scientific basis for cesarean surgery, induction of labor, augmentation of labor, positioning for labor and birth, care after birth, newborn practices, and more.

I have heard doctors and midwives complain that it is hard to keep up with the research because they are so busy delivering babies.  I have also seen that “silos” exist, where doctors only read journals in their specialty, and miss out on the research that is conducted in related fields, such as midwifery, nursing, and childbirth education.  This book captures research from many sources and packages it in a manner that is portable and easy to share with others.  The mini-reviews provide quick reference points for decision-making in non-emergency situations.

The book costs $50, and by giving it as a gift to your doctor or midwife the message it sends is priceless:  receiving evidence-based maternity care matters to you and you are willing to invest your time and your money in order to get it.

Do they already have a copy?  Suggest they re-gift it to another doctor or midwife in the practice, or to the nurse’s station on the labor and delivery floor of the hospital, or to a nurse, or a hospital administrator, or…

 

Goer, H. and Romano, A. (2012). Opimal Care In Childbirth:  The Case For a Physiologic Approach. Seattle, WA: Classic Day Publishing.

Available on Amazon.com

This is an unsolicited review and I receive no compensation for posting it.

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Cut, Stapled, & Mended:  When One Woman Reclaimed Her Body and Gave Birth On Her Own Terms After Cesarean by Roanna Rosewood

©2013 by Roanna Rosewood.

Cut, Stapled, & Mended tells the story of Roanna Rosewood’s journey to motherhood and how the births of her three children changed her life.  Fiercely independent, emotionally detached from her painful childhood, and with rebelliousness against modern medical treatment instilled in her by her holistically minded divorced parents, she faces the birth of her first child with the self-assuredness of a proud warrior as yet untested in battle.  When her planned home birth goes awry because her water breaks but labor does not start, she finds herself in the midst of a hospital birth overseen by an unknown doctor who is not supportive of Roanna’s efforts for a natural birth and on the hospital’s timeclock to force her slow labor to speed up.  Exhausted and overwhelmed, Roanna consents to a cesarean delivery.  Roanna is tied down to a surgical table, and when her son is born and screaming at his entrance into the world, she is unable to go to him, to comfort him, or even caress him.  She begins her journey to motherhood feeling like a failure.  Her body feels broken and scarred, and visions of the surgery replay in her mind while she believes that the first experience her son has had in life is one of abandonment.

When Roanna is pregnant a second time, she pursues every alternative therapy she can find that might heal her body to help her have a vaginal birth.  When this pregnancy ends in a cesarean birth as well, the doctor informs her that she had dense scar tissue, called adhesions, growing throughout her abdomen and her uterus actually tore during the birth.  She refuses her midwife’s attempts to process through the birth experience, instead choosing numbness and a grim acceptance of her belief that she is not strong enough to bring life into the world.

During her third pregnancy, Roanna takes the opportunity to go on the trip of a lifetime to Hawaii.  While away from daily life, she is able to reimagine herself as different person and mentally process through many of her life experiences and her beliefs about herself, her relationships, and her needs.  She is able to connect with some core truths, and strip away some of the armor that has shielded her emotionally since she was a child.  Finally, she is able to have an unmedicated vaginal birth.  But, even that experience, which she has dreamed about and fought for tirelessly for years, leaves her with feelings that are completely unexpected.

Birth stories teach a number of important lessons to everyone who is involved in birth.  Women who will give birth need to hear them in order to learn more about what to expect.  Men who will be fathers need to hear them to better understand how birth transforms their partners into mothers.  Doctors, midwives, nurses, other caregivers, and hospital administrators need to hear the stories of the women they work with to hear firsthand the effects of the care they give on the women they care for.  While each birth story is as unique as the woman who is telling her story, there are themes and similarities that one can identify after hearing many of them.  Ms. Rosewood’s birth stories share similarities to many other birth stories which can act as guides to help improve birth in our country.

Ms. Rosewood eloquently speaks about the physical and emotional effects of cesarean surgery on women as they enter into motherhood.  She writes about the desire for a VBAC (vaginal birth after cesarean) which many women wish for but few achieve in this country.  She writes with refreshing honesty about the surprising nature of birth and how even a seemingly “perfect” birth demands to be processed emotionally and integrated into a women’s life.  In my opinion, the value and the beauty of this book are the depth of description and the honesty about the emotional components of Ms. Rosewood’s journeys through birth because few women give voice with such clarity to this side of the experience.  The emotional truths she describes are her own, and they are similar to the truths of thousands of other women.

Birth in this country is treated as a medical condition to be managed, not as the rite of passage which contains physical, psychological, and emotional components that all must be addressed.  The mind plays a vital role before, during, and after birth.  Cut, Stapled, & Mended thoughtfully explores the side of birth that is often ignored.  In doing so it highlights both the damage and the growth that can occur during any kind of birth, and that is something all people involved in birth should be paying attention to.