I recently had the opportunity to review a book published in January, 2013, written for birthing families. The Complete Illustrated Birthing Companion; A Step-by-Step Guide to Creating the Best Birthing Plan for a Safe, Less Painful, and Successful Delivery for You and Your Baby. This book is authored by a diverse team of experts, Amanda French, M.D., an OB/Gyn, Susan Thomforde, CNM, Jeanne Faulkner, RNand Dana Rousmaniere, author of pregnancy and birth topics. I wanted to share my review with Science & Sensibility readers so you can consider if you want to add this book to your recommended reading list for expecting families. The book is available on Amazon for 14.29 and a Kindle version is available as well.

This book is marketed as a large 8 1/2 by 11 inch paperback with an attractive cover. Inside is easy to read print, a pleasant amount of white space on semi-glossy paper, along with full color photographs and illustrations. There are some beautiful photographs in there, clearly taken by talented photographers, but some of the photos seemed too unnatural, women posed in the perfect position, wearing make-up with hair just so. The pictures are all completely modest, with the exception of just one woman in a birth tub, which surprised me in a book about birth. In my experience, birth is a bit more "gritty" than represented by the pictures chosen for this book. I really appreciated the diversity of images of the women and their families, women of color and their families are well represented throughout. I also appreciated the choice of language, women have partners and those partners can be men or women.

Who is this book for?

This book for is for women who are still deciding on a birth along the spectrum of options, from a home birth to a planned cesarean. It also makes sense for women who are not quite sure what type of birth they want; they can read about all the choices as they settle on what feels good to themselves and their families. The book is written in easy to understand language, and when medical vocabulary is introduced, a definition is provided so that readers can be clearly understand what is being discussed. The book is best used for determining what type of birth a woman is interested in having. If the mother has already determined where and how she would like to birth, then this book, which is in large part a comparison of the different options, would be less useful.

Jeanne Faulkner, RN

What will families find inside?

The book starts off by asking women to imagine their perfect birth, encouraging them to hold this in their minds, but to also remember that birth requires flexibility as things can change during a pregnancy or labor that will require a deviation from what a mother was planning. A brief but accurate overview of provider types (and a good list of questions to ask providers to determine who is right for each mother) and childbirth education options are covered, and states Lamaze includes a "good, comprehensive overview of childbirth." The chapters are then divided into options by birth location as well as pain medication choices, and then goes on to cover induction, planned and unplanned cesarean. Natural coping techniques and pharmacological pain medication options are covered in a chapter toward the end, along with a guideline for writing a birth plan.

"Unmedicated Vaginal Birth at Home" or "Epidural, Vaginal Birth in the Hospital" are some of the chapter titles and for each section the authors take the time to explain what this option is, why it may or may not be right for any particular woman (in the case of home birth, why a woman might risk out of this option prenatally or in labor), the pros and cons of each option and how to best prepare if this is the choice a woman has made. Throughout the book, the authors take care to state that women should be flexible and things may change. Desiring an epidural but not having time for one is a possibility that women need to consider. I really appreciate this gentle reminder throughout the book, as I too believe that being flexible and being able to deviate from what a woman originally planned will help as the labor unfolds.

For each type of birth, women are given suggestions to help them achieve the birth they want and are encouraged to have a variety of coping techniques lined up for dealing with labor pain if they are choosing to go unmedicated. Realistic and useful advice is given, even when the birth is highly managed, so that the mother and her partner can have a positive experience.

Amanda French, M.D.

What families won't find inside?

This is not a book about pregnancy, breastfeeding, postpartum care or newborn care and it doesn't claim to be. This is a book about birth and the choices surrounding birth. Families who want to read about prenatal testing, or learn about breastfeeding techniques will want to have other books in their collection that cover those topics. While this book does a nice job covering the different options, birth locations and provider choices available to them, it does so in a very matter of fact way. There is not a lot of "rah-rah you can do it" language or encouragement for women to stretch for a low intervention option. On one hand, it is nice to have the facts. On the other hand, evidence shows that for normal, low risk women, the less interventions the better for both mother and baby. I am not sure that parents will walk away with that message after reading this book.

Would I recommend this book?

While providing a nice general overview of birth choices, I felt like there were several times that the authors wrote that women should trust their care provider's expert recommendations versus becoming more informed and discussing all options, including the right to informed refusal.

For example, in the small section on episiotomy, it reads "How do I decide whether I want an episiotomy or a tear? The short answer is this: You don't make that decision, your provider does...If your provider decides an episiotomy is absolutely necessary, for example, to get the baby out more quickly, then so be it. Your provider makes that decision based on the medical situation at hand." No mention of informing the woman, seeking consent or alternatives to cutting, for example changing position or waiting.

One of the authors, Dr. Amanda French also states several times that she stands with ACOG's statement on homebirth (which is that birth should occur in a hospital or birth center attached to a hospital) and does not believe that having a baby at home is safe. She does acknowledge a woman's right to make the decision on birth location for herself. In reading the chapter on home birth, this bias does come through.

Dana Rousmaniere

In my opinion, the book is written through the health care provider's lens. Doulas are promoted- but readers are warned to watch out for those doulas who may have a "strong personal agenda" and parents are encouraged to work with experienced doulas, instead of doulas-in-training or those just starting out. Birthing women are asked to let the anesthesiologist attempt two epidural placements, (if the first one does not work due to the mother having a "challenging back" or "not being in the ideal position") before asking for another doctor to try. Women are told to follow the recommendations of health staff in several places in the book. Families are told that their newborn will have antibiotic eye ointment and hepatitis B vaccines administered.

In the chapter on VBACs, women are told that a con of VBAC-ing is that "Vaginal delivery can result in tears in the vagina, which can be repaired immediately after delivery but may result in pain for several weeks after birth." Isn't this a risk of any vaginal delivery? For the families that I work with, I try to have mothers (and their partners) view themselves as a more equal partner in the decisions that are being made during labor and birth.

In summary

Overall, this book does a fair job of representing what to expect in eight different labor and birth scenarios, who might be a good candidate for each option and how best to be prepared. Women can read and get assistance in choosing what might be the best option for them. Information on coping techniques and even pictures of good labor positions to try are well organized for easy reference. For a woman who is undecided about where she wants to birth, this book will help her to understand the differences and the pros and cons of each location and type of birth, along with who attends births in each location. For women who are have more clarity on what type of birth they want, I might make a different birth book recommendation.

Have you read this book? Can you share your thoughts and opinion in our comments section?

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