Book Reviews

ISSN 0256-5004 (Print)

Complete list of book reviews on the AIMS website

AIMS Journal, 2005, Vol 17 No 1

Breech Birth - What are my options? by Jane Evans

AIMS Publications

Reviewed by Joanne Hood

Before I read the newest AIMS book Breech Birth, I had an extremely limited knowledge of breeches. My daughter was not in a breech presentation during the pregnancy, and so I didn't do any reading or research into breech births. My only encounter with a breech birth had been anecdotal experiences of friends. When I thought about it, I was surprised to realise that perhaps as many as a third of my friends and acquaintances had experienced breech pregnancies. Hmm, perhaps breech presentation isn't as uncommon as I'd first thought. The book also made me aware that undiagnosed breech presentation is a very real possibility for any pregnancy - including any future pregnancies that I might have. It was with this thought in mind that I went back and re-read the book with a far more critical eye. I found the book to be an excellent guide to understanding what breech birth is (it's not just bottom first!) and what it can mean for the mother (that there are options other than a caesarean). The list of possible ways to turn a breech baby was interesting to read, and very balanced in the advantages and disadvantages of each option.

Assuming the baby doesn't turn (or turns back), the book then goes on to cover the three options available to women. I was fascinated to read about the difference between breech delivery and breech birth. I also found the section relating to caesarean delivery to be pragmatic and balanced. The book gives a factual overview of the options available, and then provides further reading and contact information for women who are interested. Finally, the book is worth reading purely for its beautiful birth stories.

This is a book I will definitely be passing on to friends who have breech pregnancies in the future in the hope of informing, encouraging and empowering them to make the choices that are right for them.

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Breech Birth by Benna Waites

Free Association Books/London/New York. 57, Warren Street London W1T 5NR. ISBN 1 85343 563 5 Price: £17.99

Reviewed by Jane Evans

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Launched on the 29/10/03, this book is everything you ever wanted to know about breech birth, and probably more!

Benna Waites is a clinical psychologist who was initially moved to write this book when she was told that her first baby was in breech presentation at 36 weeks gestation. She was 'shocked by how little information there was available.' The foreword is by Obstetrician Wendy Savage, and the book moves on to a useful page on 'How to use this book', an explanation of the language, and the four main parts covering: 'What, why and how does it feel'; 'Turning breech babies'; 'The evidence on vaginal and caesarean breech birth'; through to 'Making a decision about the birth and negotiating what you want.' The book is easy to read and user friendly. The emotional impact of finding that you are carrying a breech baby is clearly covered in a sensitive, but no nonsense manner. Throughout the book the information is presented in a non-judgemental way, while always underlining that ultimately the choice and responsibility rests with you, the parents.

Waites' exploration of the available evidence is thorough, clearly presented and clearly evaluated making the it easily accessible to non-medical people. The reference system must have a special mention, not only is it numerical, but it is also alphabetical, so following up a reference is particularly easy.

There are only three criticisms that I have. One is more of a vague query as to why a woman, so motivated to question her choices for birth, appears to roll over and suggest an ultra-sound scan whenever the obstetrician suggests it (has she not read AIMS booklet Ultrasound Unsound?) The second is that the CESDI 7th report studied babies over 2.5 kg who had died, and the third is in the clinical practice chapter where there are one or two omissions or mistakes.

I feel I can do no better than to quote Wendy Savage from the foreword: "This is an excellent book which I would recommend not only for women who find themselves with a breech presentation near the end of pregnancy (term), but also to all medical students, qualified and student midwives, consultants and trainees in obstetrics."

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Informed Choice in Maternity Care by Mavis Kirkham

Palgrave, 2004. Price £18.99

Reviewed by Jean Robinson

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This is a jewel of a book that has come out at just the right time, when "choice" for pregnant and birthing women is actually official policy. It summarises much of the useful research on the barriers to women knowing about, and choosing from the care available, and how inadequate the range of options is: for example, "Would you like oral or subcutaneous vitamin K for your baby?" makes no mention of the fact that you could refuse it altogether. Here the authors draw lessons from the research which help us to see things at a much deeper level, and we come away feeling not just better informed, but wiser. I have seldom wanted to re-read chunks of a book as soon as I have finished it, but this one I re-started the next day, particularly the rich first chapter by Nadine Edwards, and the closing chapter by the Editor. Then I dipped into bits of the middle as well.

How naive we all were when we fell on the well-written, detailed informed choice leaflets from MIDIRS with such relief when they first appeared. At last women would be empowered. We should have foreseen that obstetricians would ban from their units the ones they disapproved of, midwives would be choosy over who got what, and everyone would feel threatened at the possibility of women knowing too much. The researchers described what happened as they watched. Julia Simpson's description of a doctor's behaviour is even more enlightening. If that is how they talk when they know a researcher is watching, what must it be like the rest of the time? "As obstetricians we need to learn to start being very manipulative with the women, because they are being very manipulative with us."

A book you can't afford to miss.


AIMS supports all maternity service users to navigate the system as it exists, and campaigns for a system which truly meets the needs of all. AIMS does not give medical advice, but instead we focus on helping women to find the information that they need to make informed decisions about what is right for them, and support them to have their decisions respected by their health care providers. The AIMS Helpline volunteers will be happy to provide further information and support. Please email helpline@aims.org.uk or ring 0300 365 0663.

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