Adrienne Bennett, Wendi Etherington, Daphne Hewson,
There is a baby on the cover of this book, a little baby; dressed in a white cotton gown, bathed in warm light, peacefully asleep. That is the desired end of all the choices the book will discuss. Between the reader (whether pregnant herself, or assisting a pregnant woman) and the baby lie not only the choices, but an array of attitudes (many hidden and some unspeakable as well as unspoken), fears, rituals, taboos, and superstitions. Most of the medical practices associated with childbirth today are supported by “scientific” evidence, and some of them, a hundred years hence, will indeed be found to be sound, while others will seem as barbaric as bleeding a woman in the third trimester so that the child will not drown in blood while it is born. (This practice, vividly described by Edward Shorter in A History of Women’s Bodies, was widely performed all over Europe by all classes for more than 300 years.) It is sobering to realize that practices as ‘safe’ as ultrasound have not been around long enough for their long‑term safety to be proved. Recall that x‑ray was used for 50 years, particularly to measure the relative sizes of the woman’s pelvis and the baby’s head, before the link with childhood leukaemia was seen. No one knows whether ultrasound will prove to be harmful in the long term. Like many other choices that must be made during pregnancy, this one is a matter of weighing up the risks.
Confused? Anxious? Want to know more? Childbirth Choices is an excellent reference when thinking about your labour and making your preparations. Those women who like to plan everything well before conception would profit from reading it sooner – though beware: it may put you off the whole idea. No punches are pulled in this book about the pain of labour.
Unlike many books written for the pregnant woman, this one is explicit about the kind of pain you may encounter in labour, and about the choices you have. The chapter on ‘chemical pain management’, which sensibly follows the one on ‘self-help pain management’, gives an excellent account of the drugs (‘gas’, pethidine, and epidural analgesia) commonly used in New Zealand and Australia for labour pain. Their risks, their effects – and side effects – and how they tend to make women feel are all described. The conclusions are melancholy: gas affects the baby least but doesn’t work very well; pethidine affects the baby, makes you woozy, and does little more than take the edge off the pain; while an epidural is most likely to take the pain away completely, but it does affect the baby, it often leads to a forceps delivery (because you can’t push), and there are risks to you (ranging in severity from a bad headache lasting several days, or bladder problems for several weeks, to cardiac arrest or paraplegia) depending on the skill of the person placing the needle. The folks at the hospital are unlikely to tell you all this at any time, let alone while you are in labour. Be prepared.
Written for women who want to know, and who can cope with the technical medical vocabulary (although technical terms are usually explained, the text is full of them), the book is predicated on the idea that an informed woman can make sensible choices for herself and her baby. This notion may seem unexceptionable in the everyday world. You expect your lawyer, for instance, not only to explain what is happening, but also to act on your instructions. Not so in that parallel medical universe, where we become patients, literally sufferers, who do not act but are acted upon. Given that we are also strangers here, that we may not speak the language or know the rituals, special preparation is necessary. Read this book and be empowered!
Anne French is currently researching the phenomenology of pregnancy. Her latest volume of poetry will be reviewed in the next issue of New Zealand Books.