Book Reviews

AIMS Journal, 2007, Vol 19 No 1

Birth Crisis, by Sheila Kitzinger

Published by Routledge
ISBN10:0-415-37266-6 (paperback)
ISBN10:0-415-37265-8 (hardback)

Reviewed by Rachel Burrows

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Eleven years on and I opened Sheila Kitzinger's book Birth Crisis with some trepidation or should I say outright fear. Would it re-open old wounds or at last give some sense of closure to the violation and trauma I experienced as a result of the actively managed labour and birth of my first child? Would it yet again raise more issues to be confronted, or would it answer in more detail the questions that initially swamped my head into total confusion (or near madness) and later re-emerged as I queried my role as mother. In short would I be able to relate my experience to Sheila Kitzinger's interpretations, or would I yet again be left feeling that my crisis was a result of my own inherent weaknesses?
Shelia Kitzinger draws on her many hours of listening to women's real-life experiences of childbirth, and her knowledge of the maternity system as it is experienced by women today. She presents it from an anthropologist's viewpoint. I was particularly interested to read about the power wielded by the high-tech culture of the hospital, ensuring subser vience, conformity and obedience from women and their carers alike. All of which leads to disempowerment and anxiety for mothers, and sets the scene for the pro-active management of the birth process by health professionals, which can result in PTSD. So often women are only ever presented with the medical model of pregnancy, labour and birth without any explanation of the fragile social and psychological processes involved which are easily disrupted by obstetric inter ventions.
The chapter entitled Nightmares, Flashbacks and Panic Attacks nearly caused me to close the book as I didn't recognise any of these classic but extreme symptoms. However on reading the text, particularly the quotes from women, it was clear that my experience of trauma, although not as severe, was the same emotional response. I remember well the hyper-vigilance which stopped me sleeping, eating or going to the toilet whilst alone in the house with my baby and I too still feel sick walking into the maternity hospital.
The chapter on The Baby also resonated with my experiences. The feeling of being emotionally numb and detached from the baby is captured accurately by Sheila's description of women's feelings. It was comforting to know that other women too had felt they 'didn't feel like a mother' and they too were merely 'going through the notions of motherhood'. The chapter If only I hadn't... discusses the guilt women feel about the circumstances in which they find themselves.
Sheila presents a positive way forward through listening and responding to women as they prepare for fur ther pregnancies. She gives pointers for midwives, doulas and birth partners as they help women come to terms with and heal from the trauma. Over the past eleven years I have spent a great deal of time and effort trying to make sense of my birth crisis from a variety of view points including psychotherapy, counselling and my own reading and research. Certainly this book helped me piece together and consolidate my fragmented birth story. At last I have confidence in my own interpretation of my experiences.

Real Healing after Caesarean: A victorious recovery from a traumatic birth experience by Martha Jesty

ISBN-10: 0-955-37700-5 14.99

Reviewed by Jill Moore, mother

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The title of this textbook about PN PTSD (post natal post traumatic stress disorder) is misleading. The book's proposed aim is to help PTSD sufferers and their Health Care professionals identify this condition and to treat it appropriately. It is unhelpful to suggest that PTSD is exclusive to caesarean delivered mothers and the book is clear that a traumatic birth is one perceived as such by the mother, whether vaginal or abdominal. I mention this as it is symptomatic of the book as a whole. Its aim (to support a seriously underdiagnosed section of new mothers) is laudable but its execution is patchy.
The book is separated into two sections. In the first ten chapters, Martha Jesty produces a memoir of her own experience of PN PTSD. She also includes information about her son's reaction to his traumatic birth and a section written by her husband - giving a partner's perspective. After a difficult labour and birth, a new mother can feel very isolated and unable to share her birth experience with others around her. In this context, access to other women's experiences (and through them, the feeling that you are not alone) can be enormously helpful. Martha Jesty's story certainly proves that there is a path through postnatal illness. However, these chapters are somewhat rambling, dealing with aspects of the author's life that are not necessarily relevant to the subject in hand. It should also be noted that she writes from a position of strong Christian faith. If a reader shares her faith, or is at least sympathetic towards it, then her description of how her beliefs aided her recovery will be uplifting. Jesty does clearly signal areas of the book where she discusses her condition in spiritual terms, so it is possible to skip these chapters, if they leave you feeling uncomfor table. However, her story may then seem incomplete.
The second part of the book, including a lot of information from the Birth Trauma Association, is the stronger section. Here, readers will find a very clear section entitled 'What is Post Natal Post Traumatic Stress Disorder?'; a list of symptoms; brief stories from sufferers; a list of possible triggers; the differences between PN PTSD and PND or Post Partum Psychosis; possible treatments and some charts which would enable women to monitor their own recovery. This portion of the book is clearly set out, with lots of bold subheadings, and is easily navigable for someone wanting to find out something specific about the condition. Overall, I can commend these chapters to anyone wishing to attain a better understanding of PN PTSD. With better understanding, comes a better chance of recovery and Martha Jesty's story is worthwhile for that reason - she has come through it.

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