Book Review

Outline of Contents: Introduction, and 8 chapters, including conclusion as the 8th chapter. There is a comprehensive reference list at the end of the book, which contains a varied, relevant and interesting selection. There are no illustration, tables or graphics. In Chapter 1, Mander defines support, with particular reference to social support and relates it to health. She asks us to carefully consider what constitutes support, what support is and what it is not. In Chapter 2, she looks at issues in the organization of health care and how that influences the subsequent organization of maternity care, and the effects this will have on the variety of ways in which the midwife is able to provide supportive care. She gives an overview of three systems of maternity care - UK, USA and Canada. Chapter 3 examines the need for support in childbirth and its effects, but concentrates on informal carer support. Chapter 4 provides a discussion of evidence-based practice and decision-making, continuity, choice and control, how support may be provided in various models of maternity care, and supportive midwifery during the pregnancy and after the birth. Chapter 5 presents us with an in depth look at a cross section of research relating to the benefits of the supportive presence of a labour companion in the hospital setting. She chose literature specific to midwives, nurse-midwives, nurses, lay-women with training, and lay-women without training. Chapter 6 is wholly devoted to doulas defining the term, the origins of doulas, the significance of the presence of the doula for women and what implications the use of doulas in the hospital setting might mean for midwives, and other maternity personnel. In Chapter 7 support for carers, burnout, the role of midwifery supervisors with regard to the provision of support are discussed. There is a detailed description of a research study undertaken by the author examining support for midwives who have been present at a maternal death. Chapter 8 concludes the book by an analysis of the situation the state of maternity care, and what constitutes support, and what might be forseen if the widespread introduction of the doula into maternity services eventuates. Examples of changes (which were thought would be beneficial) introduced into mainstream maternity services and their sequelae, are noted.

My Impressions: This book provides some valuable insights into support in maternity care. The individual chapters lay the backbones for whole books in themselves, but Mander brings up issues relating to support we might prefer not to acknowledge. Some readers will be shocked at the findings from the studies has cited ??me won?e. All of the studies were set in hospitals. It is worth mentioning that the studies were generated in a cross section of countries, both developing and developed, reflecting a wide range of care practices, which (as she acknowledges) makes generalisation difficult. However, it needs to be said that despite this, that common themes emerge across the studies, which are disturbing, given that one of the major roles we have as midwives is that of supporting women. This book forces us to consider the importance we attach to the women in our care, and how we actually define the ?port? provide them ??at we believe it to mean. The information on doulas presents midwives with some challenges, both personally and professionally, and provides food for thought??ander?wn research on support for midwives who have experienced the death of mother is relevant and interesting, especially because of the associated factors she identifies relating to institutional, collegial and peer support of midwives. All in all,an interesting read. I would love to see her flesh out each chapter more.

Lynne Staff
Midwife