Wednesday, April 20, 2011

Book Review of Our Bodies, Ourselves: Pregnancy and Birth

Our Bodies, Ourselves: Pregnancy and Birth, by The Boston Women’s Health Book Collective, 2008 (ISBN: 978-0743274869. Touchstone, $15, 370 pages, soft cover).

Reviewed by Molly Remer, MSW, ICCE

Many women view the book Our Bodies, Ourselves as an essential women’s health resource and also as a radically transformative influence in their lives. The Boston Women’s Health Book Collective is a confident volume specifically about pregnancy and birth. I hope Our Bodies, Ourselves: Pregnancy and Birth will become to pregnant women what the original book has been to women’s health and empowerment.

The book is divided into five major sections: The Journey to Parenthood; Your Pregnancy; Giving Birth; Becoming a Mother; and Knowledge is Power. Subsections include an extensive chapter on prenatal testing and other important areas such as childbearing loss, coping with pain, and breastfeeding. A chapter titled “Relationships, Sex, and Emotional Support” was a particularly good one. The book has numerous contributing authors from a variety of backgrounds and organizations. Sprinkled throughout the book are italicized snippets of anonymous birth stories, often paired statements—i.e. an “I loved being pregnant!” segment and an “I hated being pregnant” segment. Then, inset into each chapter in box format, there are more complete stories or profiles that include women’s names and photos. Overall, the book has very few pictures and only one series of photos of a woman actually giving birth (and she is in the semi-sitting position).

Our Bodies, Ourselves: Pregnancy and Birth is one of the only basic pregnancy books I’ve ever read that acknowledges the reality of violence against women during pregnancy and offers resources for seeking help if you are living with a violent mate. This book is also willing to address some unpopular or largely ignored subjects such as depression during pregnancy, HIV, STDS, and sexual abuse.

In the opening section of Chapter One the authors describe the “Climate of Confidence, Climate of Doubt” which becomes a thread running throughout the rest of the book. “The media’s preference for portraying emergency situations, and doctors saving babies, sends a message that birth is fraught with danger. Other factors, including the way doctors are trained, financial incentives in the health care system, and a rushed, risk-averse society, also contribute to the popular perception that childbirth is an unbearably painful, risky process to be ‘managed’ in a hospital with the use of many tests, drugs, and procedures. In such an environment, the high-tech medical care that is essential for a small proportion of mothers and babies has become the norm for almost everyone…[a] ‘climate of doubt’ that increases women’s anxiety and fear. In contrast, a climate of confidence reinforces women’s strengths and abilities and minimizes fear. Some of the factors that nourish a climate of confidence include high-quality prenatal care; healthy food and time to rest and exercise; a safe work and home environment; childbearing leave; clear, accurate information about pregnancy and birth; encouragement, love and support from those close to you; and skilled and compassionate health care providers.” I love this way of articulating the messages swirling around pregnant women in our society.

Because this book looks at birth within our current sociocultural context—which is enmeshed in a dominant medical model and climate of doubt—and because the book is designed to be a basic introduction to pregnancy book, I do feel like it sometimes veers into “climate of doubt” territory itself with all the risks, complications, prenatal testing, and so forth that it covers. However, the overriding attitude felt through this book is one that is the hallmark of Our Bodies, Ourselves in general--that ultimately, situations involving women’s bodies are about each woman and what she wants and needs. The support offered is for her regardless of the popularity of her choices with either the medical model or with childbirth activists—the woman wins out over anyone else’s agenda. This is a truly woman-centered approach.

Early on, the book also explores and explains the two models of maternity care in the chapter titled “Choosing Your Health Care Provider and Birth Setting.” The book primarily seems aligned with the midwives model of care while still containing a huge amount of information regarding the dominant, medical model.

I had a minor critique of the persistent use of the term “breast-feeding” with a hyphen, which is not correct. In addition, the book’s suggestions regarding overall newborn care routines in hospitals were surprisingly conventional and conservative.

Many of the most popular pregnancy books are rooted in medical model, conventional wisdom, and a climate of fear and doubt. This book is rooted in an empowerment oriented, woman centered midwifery model in a climate of confidence and competence. This book is a basic introduction to pregnancy and birth and is primarily directed towards the newly pregnant first time mother. I hope it finds a comfortable home on bookstore shelves next to (or in place of!) books about “what to expect” during pregnancy.

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