Becoming Parents
THE CYCLE OF LIFE, 3 vols, by Donna and Rodger Ewy '53 Dutton, 1981. 479 pp., inc. $7.25 each
For the overall trip through pregnancy and parenting these three paper-bound books will prove quite useful. They are not only a guide for prospective parents but are also a ready reference for those of us who take care of couples during this exciting and demanding period in their lives. The three volumes are heavily weighted toward the nouvelle vague in obstetrics, with special emphasis on mind-training and its value in making child-bearing and child-rearing a meaningful and instructive approach to the life cycle.
As a practitioner of the obstetrical "art" for over 30 years, I have witnessed a myriad of changes, some for the greater good and some for the satisfaction of consumer groups.
Medically speaking, there are some exceptions to be taken in the first book, Guide to a Healthy Pregnancy. The authors tend to speak in absolutes, always (sic) a danger with an inexact science such as medicine. To say that ovulation "always" takes place 14 days before the next menstrual period is to tempt the contraceptive fates. It is one of the false beliefs that leads to the downfall of the "rhythm" method. Women, to the contrary, have been found to ovulate on any given day of the cycle, including the days of menstruation! The authors write that an Rh positive baby housed in the uterus of an Rh negative mother "will affect all subsequent pregnancies," but that does not take note of the magnificent contribution of immune globulin which, if injected into the mother within 72 hours after delivery, will nearly always prevent Rh problems in the next pregnancy. There is also a serious error of omission in the discussion of Rubella (German Measles): No mention is made that if the pregnant woman has ever had Rubella she cannot get it again, and therefore can bring no harm to the baby she is carrying. Her immunity to Rubella is easily determined by a simple blood test done at the first prenatal visit.
I must be allowed those carpings.
The sections on nutrition and exercises are excellent and should be carefully noted. In our time it is rather like knocking over a straw man to recommend the principles of Family-Centered Childbirth, the title of the second volume. Most good obstetrical units, especially those in well-ordered teaching centers, are fully equipped to teach and pursue this approach, which, in essence, is simply good sense. However, one must be prepared for the fact that the labor area may be crowded with patients or involved in emergency care. The impact on the patient who has been taught to expect things to be as they were in class may be difficult to absorb. The book deals with the Lamaze technique (Psychoprophylaxis for Childbirth), but it also gets back to the precepts of the first school of Natural Childbirth as enunciated by Grantley Dick-Reade, in which the cycle of Fear-s->Tension->Pain is the problem. They intend, and rightly so, to break into that cycle at the level of "fear." If that is successful and if the woman can enter into the last stages of pregnancy with less fear this will, in turn, decrease the tension" which will, it is hoped, decrease the "pain."
I very much liked the way the authors have discussed "Interventions," giving the benefits and drawbacks of each. Their plea for education toward Caesarian Section is also well taken, given the large statistical increase in this method of delivery. Again, one small carp: They state that if a woman has been given an epidural anesthesia (a splendid variation of a "spinal" block), she will "lose the urge to push and forceps must be used". . . . This just
isn't so. In my experience, most patients with epidural block are able to push their babies into the world spontaneously, unless, of course, there is a problem of the size of the baby versus the size of the pelvis, but that has nothing to do with the anesthesia used.
Parenting: You and Your Newborn, the third volume, is a valuable adjunct in caring for the newborn, and is almost a religious appeal for the "bonding" of the entire family from the moment of birth. This particular area does not lie strictly within my limited expertise, so you may be happy to see that I found little with which to quibble.
To sum up: I find the authors lacking in some basic medical facts, but if these volumes are to be used as a reference or as a starting point for discussion with the doctor (they prefer the term "birth attendant," which I suppose I am), I recommend them. They will serve you well and may deter a harried three a.m. phone call to you-know-who.
Dr. Fielding, whose own books include The Childbirth Challenge and Pregnancy, the Best State in the Union, is on the medialfaculties of Harvard, Tufts, and BostonUniversity.
