Positive Health Online

This attractive hands-on book fills an important gap among books on childbirth by offering practical techniques to help couples achieve a happier and more natural labour and delivery.  Suzanne Yates' specialized massage strokes are highly valued in midwifery circles. They are known to ease pain and facilitate progress during labour.  By making them directly accessible to women in labour and their partners in this beautifully laid out, visually clear and well-designed Carroll and Brown book, she is able to reach a wider target audience of pregnant women directly.  The book is addressed in a warm, intimate way to a pregnant woman preparing for her 'birth journey'.

Besides Massage and Shiatsu, a range of other techniques are presented in the form of a 'toolbox', from breathing and visualization to physical preparation with exercises and from birth positions to tips for managing pain and facing 'the unexpected'.   Practical instructions are complemented with useful boxes that highlight specific topics or include additional important information: on how to make the best use of practices, when and why they are useful, possible variations and informative diagrams.  This makes the book easy to use, together with the friendly and inspiring photographs with which it is beautifully illustrated.  The book clearly supports and promotes the partnership of women and their babies' fathers during labour, including just a few images of female partners and professionals.  Realistic, practical and effective roles are suggested for men during pregnancy in preparation for birth and during labour; this is a welcome change from most birth books in which fathers only have a token presence rather than being actively involved.

The fundamental assumption underlying this book is that women's bodies are designed to cope with labour. Practices that can help women to access their inner power and strength enhance their potential to approach labour confidently. This focus on relaxed confidence pervades the book and is communicated to the reader through the skilful design and fresh colour scheme. The first impression pregnant women are likely to have when picking up this book is that a natural birth is feasible and that the techniques that are shown are relatively easy. Suzanne Yates succeeds in conveying her message that natural birth is within most women's reach.  Far from an airy-fairy ideal, the aim is to maximize comfort for all involved, mother, birth partner (ideally father) and baby through body-based techniques.

The book is clearly planned out in two main sections: the first one presents practical tools and the second guides pregnant women through labour, inviting readers to select the elements that will be most helpful to them as individuals for preparing their births.  Although the author recommends reading this book from start to finish and then going back and practising the exercises that most appeal to readers, I have found the structure slightly confusing.  For example, the book opens with breathing practices, which are then detailed for each stage of labour, before any hints are given on positions in which women can settle comfortably to breathe; it is only on page 29 that we see a picture of a woman sitting in an advanced yogic Butterfly Pose, which can be difficult for average late pregnant women without using props.  While some of the labour exercises are easy and friendly, there are simple tips that could make them more effective.  In many of the photographs, women have locked knees; it is well known that by slightly bending the knees, the pelvic tilt is more correct and more conducive to initiate strong labour.  Cautions about deep squats are appropriately listed, but few women can squat without having their backs supported.  When women are leaning on their partners' knees or sitting facing the back of a chair, however, having their feet flat is easy and helps with making better use of gravity in labour in a simple and totally safe way, even when squats are not possible.  These mixed messages around exercises that look deceptively accessible to any women weaken the physical preparation part of the book.  Massage and Shiatsu are clearly Suzanne Yates' professional expertise, and this central and most important part of her book is excellent.  She honestly acknowledges her borrowing of New Zealand Pink Kit techniques, a refreshing gesture that singles out her integrity.  Clear instructions for massaging the back and the sacrum, the use of labour focus points and pain relief techniques for each stage of labour make this book an invaluable resource.  Yet again in the second part the structure is unclear:  the choice of a birth partner, the visualization of a birth space and forms of communication with the baby to be born follow - rather than precede - detailed practical resources for each stage of labour.  A well-made index does not quite compensate for this disconcerting organization of the material.

This lack of logical sequencing of topics undermines the clarity of the design.  A woman expecting her first baby, with relatively little background knowledge on labour, would probably like to become familiar with simple general practices before getting acquainted with practices that can address particular problems or conditions. There is also a surprising lack of both information and practices associated with the pelvic floor in this book.  It is only presented in relation to the second stage of labour on page 43. Given the known importance of pelvic floor awareness for birth and the usefulness of practices that promote greater elasticity of the perineum, particularly for first time mothers, the scant reference to this crucial aspect of birth is questionable.

The appeal of this book to professionals working around birth is possibly just as great or even greater than it might be to pregnant couples.  Midwives, doulas birth educators and prenatal yoga teachers will most probably skip the general parts of the book and focus on its unique contribution: how to use massage and shiatsu effectively during labour.  The value of facilitating positive touch and communication between pregnant and birthing women and their partners, however, defusing tension and anxiety, overrides any of the structural weaknesses outlined above.  Promoting an atmosphere of ease and trust in which labouring women can remain calm and confident is the most conducive way to achieve the physiological labour we know is accessible to most women. The inspiring statements interspersed through the sections: 'fluid, tension free movements'; '...letting the body give birth...' pass on to readers the clear conviction of the author that birth can be a beautiful experience to be enjoyed.  This, together with wonderful Massage and Shiatsu practices, is her main gift in this book.