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Nurturing Birth Book Review: Dynamic Positions in Birth

Book Review by Sally Carter

Front cover of the book "Dynamic Positions in Birth". The book has a bright purple colour, with the title across the top in white. Underneath is a graphic of a woman on her back, replicated 8 times with a slight turn so that it becomes a woman on all fours.

Dynamic Positions in Birth (2nd edition) by Margaret Jowitt is published by Pinter and Martin and costs £12.99

Dynamic Positions in Birth was an informative and at times compelling read.

As a doula, I understand the physiology of childbirth and the relevance of active, upright positions during labour and birth. This book has helped me to have a better, far deeper knowledge and understanding of the biomechanical and scientific theories behind why birth might unfold in the way it does and how the development of mankind and the medical profession has influenced and birth practices, & not always for the better.

I enjoyed the chapter on “Birth Furniture through the ages” which gives a timeline of the use and development of birthing stools, chairs, and other furniture for birth which then lead to the modern obstetric bed.  “Research Evidence” was also fascinating. This chapter discussed the pros and cons of observational study and clinical trials. The section on the Cochrane reviews of these studies was particularly interesting.

“Cochrane proposed that treatment based purely on medical opinion (or preference) should be replaced by treatment based on clinical research evidence obtained through randomised clinical trials (RCT’s).”

This led me to consider the amount of seemingly opinion based recommendations that are reported being given to women/birthing people nowadays, even though healthcare professionals should be using evidence based research to support their recommendations, ensuring women/birthing people are making informed choices. A lack of time and willingness to fully support informed decision making leaves us back in a place where medical preference often supersedes the individuals’ preferences.  

Jowitt’s visual models of the balloon and trampoline are also helpful in considering the actions of the uterus.

I found the later four chapters more easily accessible and informative when it comes to describing the passage of the baby through the pelvis and what Jowitt sees as how we can “make birth better”. For instance, she recommends that Midwives not only suggest changes of position, to the woman/birthing person, so that they can tick the box that they’ve done so, but that they actively encourage and support them to adopt upright positions. This is also when she revisits the importance of changing the emphasis in birthing rooms from the bed to other pieces of furniture or equipment that would support upright birth, and also to support midwives to be more physically comfortable and able to facilitate upright birth.

This book could be viewed as a feminist text (after all, isn’t birth a feminist issue?) with its references to the history and development of mankind and the birthing process. How once the patriarchy became involved and birth was seen as a way to profit and build stature within society for men, the voice of the woman/birthing person became supressed, and they were coerced to ignore and go against their natural instincts. For this, I applaud Jowitt.

However, I am a little disappointed in the hetro-normative narrative of the book – especially when the topic itself would lend so beautifully to a more gender-neutral and inclusive use of language. If you are going to “update” a work for the 2020 population, then surely you have a responsibility to make it as inclusive as possible?

I also found it quite hard going at times. I would say this is a book for birth workers rather than for the expectant parent audience, although anyone who is pregnant and has a more academic background might also find it informative. It certainly contains some very important messages about the power of position in labour and birth, and how reclaiming physiological birth would be empowering and beneficial to not just parents and babies, but also to our midwives and the maternity system as a whole.

Overall, I found this book to be very informative. It raises important issues, especially around upright birth being the physiological norm, and how understanding how different positions in labour can significantly affect birth. These are facts which are acknowledged by lay birth workers and midwives who wish to “be with” women/birthing people and that the medical maternity world needs to wake up to.

Sally Carter is a Nurturing Birth Doula. Click here for the link to Sally’s Nurturing Birth Directory entry.

Nurturing Birth Book Review: Understanding Babies: How engaging with your baby’s movement development helps build a loving relationship

Book Review by Ruth Patel

Understanding Babies: How engaging with your baby’s movement development helps build a loving relationship by Ania Witkowska is available from Pinter and Martin for £9.99

I am a mum to three very different kids, who had three very different birth experiences and grew up with their own varying temperaments and needs. Therefore I was interested to come to this book and to see through what lens the author gazed upon the early days. The book was published in 2021, sadly after the death of its author, Ania. The term ‘mother’ is used throughout this book to refer to the birthing parent.

What is woven within the pages of this book is a tender narrative of baby’s attachment, development, observations, play, links to you and their surroundings, what you can do as a parent to nurture and encourage their sense of self and how you as a parent can feel confident and equipped to navigate the early days.

Ania Witkowska is a movement specialist whose work has looked at what a baby needs in order to thrive, as well as how parents you can tune into their baby’s needs and development so they can ‘feel more joy and less anxiety.’

The book covers five key areas including emotional regulation, love, movement, play and day to day. Throughout each chapter, she details how you and your baby may feel and your needs in this particular area.

Each chapter has an accompanying mp3 guided session which can be downloaded at www.pinterandmartin.com/understanding-babies.  These are somatic awareness exercises and movements to help you notice what is going on in your body and thoughts. Going through these guided sessions made me feel supported, created a restorative space in my busy day and gave me permission to feel and notice what was going in on in my body.

I feel she touches on almost every part of the first few months and how you might feel postpartum as a mother. Beginning with “before she can fully engage with the world, your baby has to feel safe and happy simply being in it”, touching on their movements as they pass through their developmental milestones, and ending in when things are a little more difficult. The author gives the reader permission to feel all the feelings that a new mother can experience.

I particularly enjoyed the part on how your baby notices their surroundings and the permission it gives to parents to let their babe be mindful of simple experiences such as looking around, the attention on a certain object, the tight squeezing of a finger. Ania asserts that all these things develop their brain, development and attachment to the caregiver. My own babies used to fixate on certain objects in a room, picture frames, wall lights, the wind outside, and I would always think “I wonder what they’re thinking?”

This book began by looking at baby’s emotional regulation and ends with emotional regulation of the mother. I love that. In order to regulate our babies, we need to regulate ourselves. Understanding oneself and our emotions and how to regulate our emotions, is a huge life skill that is invaluable.

 The emotional resource checklist that Ania includes asks such important questions about emotional regulation. A far cry from the form the midwife gives you asking questions such as “have you felt overwhelmed…depressed… unable to cope” and then leaves you in that place saying oh your score is ok, I’ll leave you to it. How about asking some of these questions, “what usually helps you feel better when you feel stressed or overwhelmed?” “Do you know what specific help to ask for when you’re feeling X” (rather than just a general ‘I need help’). One reads Ania’s book and feels supported and gently encouraged; validated as a mother with all the feelings that come with the role.

Throughout Ania’s book her aim is to guide you and give you confidence through the early days of parenting, helping you trust your instincts and connect with them.   If you would like to be gently reassured about parenting, then this book is for you. My only criticism is that the chapters are rather long, but well worth making some time to go through! Remember, as Ania says:

“The journey is as much about us as it is about our babies”

Ruth Patel is a doula based in Shropshire and was trained by Nurturing Birth. She has a special interest in maternal wellbeing and alongside her doula work, runs a post natal support group locally. She can be found @yourbirthmaid and www.yourbirthmaid.co.uk