My ultimate test for a book is whether I would recommend it to my daughter-in-law or to my sister. The answer for this book is, “Yes.” However, I would be recommending the book to my son or brother-in-law as this concise, little book is addressed specifically to the labor partner. What I like about this book:
• It is a small book; not counting the Appendices, it has 89 pages. I hate to give in to stereotypes, but I think for many men (including my son), the likelihood of them actually reading a childbirth book is directly related to its length.
• It promotes a natural approach to birth. Although the authors say that they don’t endorse any particular method of childbirth, they do promote birth with as few interventions as possible. They are open about the risks associated with epidural analgesia.
• They promote doulas. In fact, one of the authors is a doula herself and both authors used doulas with their own births.
• The tone is very encouraging for male partners – even if you are scared and nervous, you can “deliver” (support).
• The key point of the book is that a laboring woman cannot have too much encouragement. The authors stress not offering a woman medication. (If she wants it, she can ask herself.)
• I like the discussion about adrenalin and oxytocin.
• The book does a very nice job on birth plans.
• The books encourages attendance at childbirth education classes, which I strongly agree with for the same reasons as the authors.
• The authors have a website (www.deliverbook.com) with a nice list of recommended reading and other resources such as suggestions for music for labor.
I have a few small quibbles (I am very picky).
• The authors acknowledge that a laboring woman may have a female partner such as friend, sister, or mother, but they do not acknowledge the Gay, Lesbian, and Trans-Gender population.
• The authors discuss prenatal optimal fetal positioning. As far as I know, research supports position changes during labor to help rotate a baby into an optimal position, but not positive results from practicing certain positions prenatally. I do not like the idea of a partner telling a pregnant woman late in pregnancy to sit up straight in order to make sure her baby is in the best position for labor. (However she can get comfortable is fine with me!)
• The authors say that a warm bath should only be used if the membranes are intact. Most institutions that I know of (who provide tubs for labor) are fine with the laboring woman getting into a tub with ruptured membranes. More space could have been given to the pain-relieving benefits of tubs.
• The authors do say that the baby should be placed immediately on the mother’s chest, but they also say that this is not usually done with cesareans. (That may be true, but that should change.) I wish they had discussed the “belly-crawl” and letting the baby self-latch with uninterrupted skin-to-skin contact until the baby accomplishes the first feeding on his own.
What is missing from the book such as information about the risks and harms of routine medical interventions should be covered in good quality childbirth classes. All in all, this is a nice little book to provide an overview of labor and birth and encouragement for the male partner.
I am currently reading up on OFP and wonder if you have a reference for this comment:
• The authors discuss prenatal optimal fetal positioning. As far as I know, research supports position changes during labor to help rotate a baby into an optimal position, but not positive results from practicing certain positions prenatally. I do not like the idea of a partner telling a pregnant woman late in pregnancy to sit up straight in order to make sure her baby is in the best position for labor. (However she can get comfortable is fine with me!)
Thank you!
Kathleen
Kathleen,
I remember when I first read Optimal Fetal Positioning. I loved it and it made a lot of sense to me. I asked a friend of mine who was at the time the director of a nurse-midwifery program to review it for me. She also enjoyed reading it and said that it made a lot of sense to her, but that there wasn’t any evidence to support it. There is one study (not a perfect study) from Australia that did not find any benefits from pregnant women assuming a hands and knees position daily in the last weeks of pregnancy:
Kariminia, A., Chamberlain, M.E., Keogh, J., and Shea, A. (2004). Randomised control trial of effect of hands and knees posturing on incidence of occiput posterior position at birth, BMJ, 328(7438), 490.
The 2007 Cochrane Review on hands and knees posture in late pregnancy for fetal malposition also did not find any benefits:
http://summaries.cochrane.org/CD001063/hands-and-knees-posture-in-late-pregnancy-or-labour-for-fetal-malposition-lateral-or-posterior
And a fascinating 2005 study by Lieberamn found that fetal position changes are common in labor, with the final fetal position established close to delivery. (Babies change position frequently throughout labor!)
Lieberman, E. Davidson, K., Lee-Parritz, A. and Shearer, E. Changes in fetal position during labor and their association with epidural analgesia. Obstetrics & Gynecology, 105(5 pt.1), 974-82.
A very good review of all the issues associated with the OP position is:
Simkin, P. (2010). The fetal occiput posterior position: State of the science and a new perspective. Birth, 37(1), 61-71.
I still encourage laboring women to try a hands and knees position during labor to decrease back pain and possibly to help an OP baby to rotate to an AP position. I encourage good body mechanics and posture during pregnancy. But I no longer tell pregnant women to never relax back into a chair or sofa at the end of a long day.
Debby (Amis)