1. Austin, Dorothy A. CNM, MS

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A Holistic Guide to Embracing Pregnancy, Childbirth and Motherhood: Wisdom and Advice from a Doula, by Karen Salt, Cambridge, Mass: Perseus Publishing; 2003. 213 pages, paperback, $15.95.


Although the content seems similar, this "doula book" by Karen Salt is written from a completely different perspective. While Klaus, Kennell, and Klaus focus on the definetion and delineation of the role of a doula, and the very solid evidence of the positive impact a doula can have on birth outcome, Karen Salt's book is a source of information on pregnancy, childbirth, and motherhood written for the woman wanting to prepare for these events. It is written from the author's own experience and offers personal accounts, as well as advice from a practicing doula. (Hence, the subtitle "Wisdom and Advice from a Doula"). Salt addresses the reader from a holistic approach, as "more than a pregnant person about to give birth" but as "a friend, a lover, a daughter and a woman" with whom she wishes to share information. She states her intent to show the reader "the strength within her to experience birth with love, joy and confidence." The entire book maintains this positive and empowering voice.


The book is divided into 3 sections: Part I: Pregnancy, Part II: Childbirth, and Part III: Motherhood. Under each of these sections there are 3 chapters that focus on mind, body, and spirit.


The pregnancy chapters address the period of transitions. Starting with "Your Pregnant Mind," it gives specific information about physiologic changes in simple easy to understand terms. Explanations of changes, such as increasing hormone levels and their effect on a woman's emotions, are described along with practical and specific strategies to manage such symptoms. Techniques are suggested to decrease stress by use of journaling, exercises to connect and share with your partner, exercises to visualize your baby, use of massage, candles, music, and water to enhance relaxation. The next chapter focuses on "Your Pregnant Body" and again describes the dramatic changes the body is encountering, with brief explanations and practical ways to ensure nutritious eating, getting enough to drink, and incorporating exercise in a way that enhances bloodflow and decreases stress. The third chapter, "Your Pregnant Spirit," looks at the pregnant spirit and emphasizes ways to "infuse the soul" with positive energy such as resting when you feel tired, believing in yourself, laughing often, and asking for help when you need it.


Part II follows the same philosophy to "Embrace Childbirth." The author focuses on the transformation taking place, as both partners become parents. The concept of a Birth Philosophy or Birth Plan is discussed encouraging couples to consider very carefully the elements of the birthing experience that are most important to them, advising them to be realistic, and not to rule out options of pain relief or any intervention that is needed to ensure the safety of the baby. Examining beliefs and knowing as much as possible about how and why certain things are important can help to make the birth plan more flexible in the event of complications. Salt continually presents these ideas in a way that encourages a woman to embrace the concept of a holistic philosophy and try to apply it as best way possible in any setting, even in the event of a cross-section. There is praise for the progress that hospitals have made toward more family-focused care, services that are more adaptable to a woman's specific requests, the availability of lactation consultants, and closed-circuit hospital TV channels giving 24-hour baby care programming. There is never a negative tone or criticism of hospitals or medical professionals, just recognition that birth has become a medical event that commonly takes place in a high-tech setting. The author offers suggestions for ways to get the best possible experience and not focus on the setting.


Part III addresses "Embracing Motherhood." The author gives equal time and attention to the postpartum period, as did the Klaus, Kennell, and Klaus book. Salt stays true to the positive focus and feeling of empowerment by entitling the chapters: Your Balanced Mind, Your Beautiful Body, and Your Spiritual Connection. Similar to the other chapters, the book addresses how to nurture and respect your recovering body with specific suggestions for dealing with common discomforts, breastfeeding challenges, returning to exercise, but advises staying in tune with the needs of your body, not obsessing with weight loss and how soon you can return to a size 8. She discusses at length the return to sexual activity, which is another area overlooked by most literature and counters commonly believed myths regarding sexual intimacy after childbirth.


The book concludes with a resource list for "Help, Advise & Inspiration."


Both books give very valuable insight on the positive impact a doula may have on pregnancy, labor, and birth outcomes. Although from very different perspectives, both provide information helpful for women and their families, as well as for staff working in the obstetrical field. Karen Salt takes it one step further, as an ambassador for her profession. Even in the written text, one is moved by her conviction to the strength of women. Her words empower and inspire.