Book Review: Confident Birth by Susanna Heli

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AIMS Journal, 2018, Vol 30 No 2

Confident Birth By Susanna Heli; reviewed by Paula Cleary

Pinter & Martin, 1st Edition, 2012 Author: Susanna Heli ISBN 978-1780660400 Price £9.99 Paperback 192 pages Reviewed by Paula Cleary Find this book on Amazon

Confident Birth is a little gem of a book. The author is an experienced doula and physiotherapist and the book, translated from her native tongue (Swedish), is based on her own experiences in Sweden and includes nuggets of wisdom gleaned from teachers in her life. Her method of building confidence in giving birth is based upon four tools of Breathing, Relaxation, Sound and Power of the Mind – all of which she talks about in detail in the book, including how she came to understand their power and effectiveness. Susanna reassuringly guides expectant parents on a journey of non-judgement and self-compassion (all feelings are allowed), talking them through what the sensations of labour feel like, and how we can either get locked into negative cycles or positive ones in response to the intensity of birth. In her words “to protect against fear and stress during labour it is necessary to build a foundation of trust”. Pertinently, she also explains that “panic and extreme fear should be seen as the most severe complications of labour, and great effort should be put in place to try and avoid these feelings”.

The reader learns how positive psychology impacts on the body, kickstarting the ‘reward system of the brain’, and about the beneficial hormones, such as oxytocin, that are released when women are able to make the switch from responding to labour with fear to finding a way to relax and allow the birth to become stronger. She talks about the benefits of soundless breathing and explains why that is more effective than shallow or very noisy breathing; how massage and experiencing a feeling of heaviness can help relax the parasympathetic nervous system; how making low deep noises from the belly can help a woman to access strength; and how using simple words such as ‘yes’ or ‘open’ can have a powerful effect. In my own experiences of giving birth, I can identify how I have instinctively been using these tools for myself, and how powerful it is to say ‘yes’ to the birth, to the growing intensity. When I read the part about using a low deep voice I also had some funny flashbacks to a time at a birth I was supporting as a doula. I and the mama growled together through about half an hour of contractions, like bears or who-knows-what wild animal! I’m sure the staff thought we were mad, but it absolutely worked to switch from high pitched panicky cries to deep guttural sounds!

The book is full of such stories which illustrate the difference and shift in a woman’s ability to cope with labour once she switches from feeling panicky to being guided to use coping tools. This helps the reader to understand the principles in action and have confidence that they work!

Susanna talks readers through the intensity of contractions, putting them into a context as something that is easier to endure when you recognise there is no need to be afraid, and that the pain has a purpose and that purpose is very normal and functional. She describes how, “Pain during childbirth is very different from the pain caused by an injury or trauma and doesn’t have to involve suffering… destructive pain signals injury, while pain during labour tells the story of physical transformations in your body”.

This is a very practical and straightforward book which, whilst discussing the emotional, does not stray into the realms of the spiritual dynamics of birth, so will appeal to those who don’t want to read anything too ‘hippy’. It also stays clear of birth politics, power dynamics, birth plans, or feminist issues (something which keeps the book neat and tidy from one perspective but perhaps leaves it slightly lacking if you like to look at those aspects of birth).

Whilst this is a great little book in so many ways, I do have a couple of tiny criticisms. Firstly, it is very much designed with straightforward birth in mind, so is fine if you have a completely straightforward vaginal birth. There is nothing to help readers that don’t fit neatly into that bracket, and nothing about the maze of choices for mothers either side of normal physiological birth at full term. If birth takes a turn, there’s no comfort, no explanation of how to carry that confidence over to the operating table, or other such non-ideal scenarios. I also found that, particularly in the first half of the book, Susannah had a habit of finding ten different ways of making the same point using the same words in a different order, which made them feel more than a little repetitive, and I felt a more brutal edit would have resulted in the same message being communicated to readers and spared us having to read quite so many pages. You could probably cut this book down by 30 pages or so, without losing anything.

In spite of these small niggles, it really is a gem of a book. It is one I will definitely keep in my doula library and have already lent out a copy to one of my antenatal clients, who went from being very set on hospital birth to choosing to give birth at home, which she did beautifully. A combination of positive education from different teachers in real life and book form. Such is the power of positive stories, and this book is full of them!

Reviewed for AIMS by Paula Cleary