My Mini Midwife
This book has been written for a lay audience by Denyse Kirkby, a midwifery lecturer and public health practitioner. The book is intended as a ‘guide for mums-to-be looking for straight-up, easy-to-read answers to commonly asked questions’ during pregnancy and also for the early postnatal period. Denyse's informal, conversational style is suited to the target audience.
The book is divided into 15 short chapters, each focused on one aspect of pregnancy, birth, and the penultimate chapter, intriguingly called ‘The Postnatal Map’. There are text boxes inserted throughout the book offering additional snippets of information in the form of ‘Health Facts’, ‘Exercise Shortcuts’, ‘Did You Know?’ and ‘Be Money Wise’, which range from common-sense information about taking exercise in the form of walking, to money saving tips such as batch cooking and freezing meals ready for the early days of parenthood. Some of the boxes, however, don't seem to fit comfortably where they are placed such as a ‘Be Money Wise’ tip on home-made versus shop-bought bread at the end of the labour chapter.
Information is presented in a professional but informal style. The informality and lack of reference to evidence on which the advice is formed feels uncomfortable in places as it assumes a level of professional paternalism. There are instances where the advice or information is at odds with the current guidance within National Institute of Health and Care Excellence (NICE) pathways, which may lead to confusion or unnecessary anxiety in the reader.
There seems to be a gap in the provision of information between conception, early pregnancy and antenatal screening tests. Information regarding what options are available for accessing maternity services following a positive pregnancy test and how to complete a self-referral to a midwife would have enhanced the section on early pregnancy.
In the chapter providing information on antenatal care, Denyse outlines the expectations of care at antenatal appointments and these in general follow the NICE guideline pathway. There is no reference to the NICE guidance or signposting to the website for further information, however, which would be useful. Routine elements that are no longer included in NICE antenatal pathway such as urinalysis at each visit for ‘sugar’ and the midwife ‘listening to the baby's heart rate’ are included as expected procedures.
There are some other elements that may need to be interpreted with caution as the evidence on which the advice is formulated has not been provided; for example, the author recommends that in pregnancy women stop using aerosol deodorant and change to roll-on versions and do not use hair dyes. It is also stated that the ‘majority of women with type 1 and type 2 diabetes will have a caesarean section’ and that intercourse is the best method of induction followed by amniotomy. Further information regarding medical induction and what to expect, particularly in relation to out-patient induction and how long it might take for labour to begin, would be helpful in enabling the reader form realistic expectations of the process.
The book would have benefitted from the addition of a chapter with some ideas of how to promote the factors that facilitate a normal birth. The labour section is very short and focuses on the signs of established (‘true’) and non-established (‘false’) labour. The next chapter moves directly on to types of pain relief.
The last chapter of the book covers a selection of frequently asked questions and covers a wide range of subjects from ‘when can I go home?’ to ‘how are surrogacies arranged?’, with the author giving answers to the questions posed. Directing the reader to further sources of information, evidence or advice to support the answers given would have enhanced this final section. There are very few diagrams in the book; there are two line drawings within the breastfeeding section but it is not clear what they depict and they are not labelled, so are not overly helpful. Other black and white drawings depict the fertile cycle, amniocentesis and a six-step swaddling guide.
Overall I was rather disappointed with the book and the lack of evidence to support the information given. In parts it feels quite dated, for example the common-sense suggestions in the ‘Be Money Wise’ boxes such as the best time of day to shop for reduced priced foods, and that borrowing parenting books from friends, family or a library is more economical than purchasing them.
Due to the lack of reference to the evidence, the tone of the book is one of professional opinion rather than offering the evidence and possible options. The author does, however, signpost readers to her website for the most up-to-date guidance, which then has links to some sources of information referred to within the book.