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Book Review “What to Expect When You’re Expecting” 

RATING 0/10

NOT RECOMMENDED 

By Arlene Eisenberg, Heidi E. Murkoff and Sandee E. Hathaway B.S.N. With a foreword by Dr Richard Aubry, Director of Obstetrics, State University of New York Health Sciences.

 

This book has best seller emblazened across the front cover to create an immensely popular image, and in fact it is probably the most widely sold but certainly not the most popular, book on pregnancy in the Australian market. Nearly all bookstores have it on the shelf and because readers see it in every store it's presumed to be "the one" to get.

Unfortunately, it's not until women start reading through it that their reaction to it turns sour, as it reveals it's true message, that of fear mongering and increasing women's anxiety and reducing their confidence in their body's ability to grow a healthy baby and birth normally. It disempowers, confuses and worries pregnant women. Quite often in pre-natal classes when women compare the variety of books they are all reading this is the one that they say they didn't like, it scared them and sent them running back to their midwife or doctor in need of reassurance. Many women then report that they decided not to read anything at all after that experience! How sad as we have so many really great Australian books available to women which might not have the same mega profit margin for booksellers, but are far more practical, realistic, suitable and  useful, to our strong, healthy, sensible, and very capable Australian pregnant women.

Midwives groan at the mention of the book and advise women to use it as a door stop!

 

 

The description of Second stage On page 299 really sums up the general tone of the book with:

“Up to this point, your active participation in the birth of your child has been negligible.        Though you’ve undeniably taken the brunt of the abuse in the proceedings,  your cervix and uterus (and baby) have done most of the work. But now that dilatation is complete, your help is needed to push the baby the remainder of the way through the birth canal and out.”

Clearly, the authors understanding and appreciation for the emotional journey a women experiences both during her pregnancy as she reads this book perhaps looking for guidance, reassurance and compassionate information, show an extraordinary lack of sensitivty or respect.  The insensitive description over the next few pages continues with “Pushing - Give it all you’ve got!” and the attitude of episiotomy and outlet forceps as normal and routine, which is certainly not in line with current evidence, researched based information or the World Health Organisation recommendations. 

This book has been available in Australia for about 15 years, I decided I should really buy a copy and have a read of it, after I noticed a general increase in anxiety, amongst those women attending pre-natal education sessions, who had read the book, which caused me to be curious over their source of information.   I also had become aware of odd questions being asked on a regular basis and upon enquiring with groups, about what they had been reading the title "What to Expect..." kept coming up.  Clearly, this was a popular book!    From one group to the next; the same unusual questions such as; "Is it ok to have a warm bath during pregnancy?" and "Are you sure it's ok to have sex with my partner during the last month of a normal pregnancy?" and "Is it really essential that I lay only on my left hand side all night every night during my pregnancy?" and "Do I really have to eat that massive amount of food on the What To Eat Diet list?"

After purchasing it, I read the whole book cover to cover. The first aspect of the book that caught my attention was the "pretty feminine" cover and the fact that there were 3 women’s names on the front cover as the author’s. Clearly very appealing and attractive. I imagined when newly pregnant women are selecting a book for purchase they will view a book with female names as a credible source of information.  

 

However, I became perplexed as I read the foreword by the obstetrician – Dr Aubrey – who made a very strong point of actively denying he wrote the book…  I decided to read on… surely the underlying attitude conveyed in the book would be a clear indication.

We know from our training and experience in childbirth and parenting education that the way language is used when conveying information and concepts to women and their partners will have a tremendous positive or negative impact on their feelings and perceptions.  Take for example just the first 40 pages of this book… it is riddled with medical jargon “gestational sac” and bold headlines within each chapter such as “Previous Abortions”  “Fibroids”  “Incompetent Cervix” “Tempting Fate the Second Time Around”  “Obesity”  “Herpes"  “Fear of AIDS”  “DES”  and “Genetic Problems”. 

The attitude conveyed throughout the book will cause the informed experienced reader to gasp with shock, burst out laughing, or become nauseous!   

 

On page 8 the question is posed to the reader “What kind of patient are you?”  With follow on comments such as “Do you believe the doctor knows best – after all he or she’s the one who went to medical school” …   Doctors in Australia stopped asking such questions a long time ago when it's quite possible their patient could well have a double degree.

The underlying assumption throughout the whole book is that a woman will automatically have a private obstetrician, which is not automatically routine in Australia and again, is against the standard recommendations of the World Health Organisation, that is seen as the recognised authority for setting safe standards and appropriate recommendations. The WHO recommends that all normal healthy women be cared for throughout their pregnancy by a qualified midwife who is recognised as the safe and suitable health care provider, for a healthy pregnant woman and that the midwife will refer to a doctor if a medical condition or complication arose.  The choices and options available to Australian women are virtually ignored. The language of “certified nurse-midwife” and the low status afforded to midwives throughout this book is demeaning towards midwives, conveying the attitude of midwives as simply handmaidens to the obstetricians.  Midwives are referred to as “nurse” or “hospital staff”.The skill and dedication of our midwives in Australia is certainly not portrayed with respect in this book. Water births, which are becoming far more mainstream and commonly available in many public maternity hospitals and birth centres are only mentioned briefly with a tiny negative paragraph, how out of touch!

Our Dept of Health produces publications outlining and informing health consumer’s of their rights and responsibilities and I noticed that those concepts were completely ignored in this book. I checked the index just to be sure and you guessed it “women’s rights as a health consumer” or any listing of “rights” was completely unavailable.

This USA book has only been "Australianised" by crossing out the word diaper and replacing it with nappy.                       

Are interested to know what I have done with my copy of the book?

I invited two wonderful wise women friends around to join me, Geoff built us a lovely fire in the backyard, we tore the book into three sections and then flicked through with each taking turns to read a little out from any page, competing with each other on who could read out the most negative, disempowering, offensively worded passages from the book before tearing the page from the section and tossing it into the fire. Thank you to my dear friends Leah and Victoria for the laughs during the cathartic burning ceremony, it was great fun, and a good feeling to get rid of a book that has done such a disservice to so many wonderful Australian women.

RATING 0/10

NOT RECOMMENDED