The Birth Partner; a book review

Posted by on March 22, 2018

The Birth Partner: A Complete Guide to Childbirth for Dads, Doulas and All Other Labor Companions, 4th Edition, By Penny Simkin


If, as a birth partner or companion, you do nothing but read this single book and implement a small fraction of the advice and suggestions presented, you will have made a positive difference in the birth experience!  Labor support is a tremendous job, and the information available can be overwhelming so it’s important and valuable to have simple, concise guides like this one. But this is also a great read for the birthing person themselves.  I suggest to my clients (both birthing person and the partner) that if they don't read anything else, this is “the one” to read!


Penny Simkin began working as a doula and childbirth educator in 1968, and over the next several decades she gained experience, and then some, from which to write this book.  It remains relevant and up-to-date with this 4th edition, and continues to provide high quality information.


The book is broken into simple and useful sections and chapters, and begins with The Last Weeks of Pregnancy.  The topics in this chapter can be used like a complete checklist of the last things to prepare for. The topics could also make a useful outline for new doulas to use during prenatal visits.  I also really appreciate her list for the essential baby items; it's easy for expecting parents to be overwhelmed with all the baby products on the market so this list really brings it back to the basics and all that you really need for a newborn.


The book then progresses through the process from start to finish in the next section, Labor and Birth, and really attempts to cover any and all situations a birth may potentially present.  I really like that she prepares folks for a ‘pre-labor’ phase of labor as a part of the process that is common and normal, because it is! I also really like that she discourages the term ‘false labor’, because it isn't!  In the print version of this book, there are very convenient shaded tabs for quick reference covering things a birth partner may need to look up or be reminded of in the moment, ie. Signs of Labor, Timing Contractions,The ‘Take-Charge-Routine’, Emergency Deliveries and more.  A new addition to this current edition is the section explaining pain vs. suffering which I think is very helpful for partners to understand, and especially for couples preferring for no pain medications.


Then comes the section on The Medical Side of Childbirth covering common complications and interventions all the way through cesarean births.  The information regarding pain medication options is very thorough, however, out of all the options described only 3-4 are commonly available in my area.  The PMPS is a valuable tool to use in my doula work. It is great to have common language for communicating preferences on the continuum it represents. And I think the coverage on cesareans is appropriate in several ways: she gently covers the issue of cesarean overuse, gives just the right amount of preparation info (for someone who isn’t planning a cesarean), and also gives a big picture view by discussing VBAC.  I think one consideration that often isn’t considered when a first-timer is faced with that decision is how it can affect future pregnancies and births.


The book wraps up with The First Few Days Postpartum and Getting Started Breastfeeding; she describes common procedures immediately after the baby is born, gives a brief overview of newborn care in the first few days, and gives helpful tips to get breastfeeding off to a good start.  And it concludes with some encouraging parting words, and a very thorough resource and reference compilation.


As much as I love this book, I do have some critiques. There are numerous times in the book where she presents some information as though it is standard practice at all hospitals, when it is in fact not standard practice at the hospitals where I practice.  For example the information she presents about the situation where the water breaks before contractions have started, or PROM. The management strategies she describes are not often offered in my area (expectant management is virtually unheard of, compared to active management), and there is no distinguishing between leaking fluid and gushing fluid- both situations are treated the same.


I do wish the chapter covering comfort measures was better organized; there's a helpful chart for labor positions but it would be nice if there was one for an overview of all of the techniques.  I am surprised that there is no mention of the natural hormones that regulate birth and help with pain perception and tolerance. I think this is helpful information to help women understand the natural, physiological process whether or not they are planning on using pain medications.  In my experience, this knowledge helps them trust their bodies and the process more.


Going into the section regarding interventions and procedures, I would like to see more information on the overuse of inductions for non-medical reasons as this is such an increasing and prevalent problem in U.S. maternity care.  And I’m surprised she doesn’t use one of the common acronyms (BRAN, BRAND, BRAIN, etc.) to simplify the informed decision making process. In the attempt to provide broad spectrum information, the chapter regarding complications might be a bit overwhelming to some.  I struggle with this cutoff point too, in teaching childbirth education, of how much information is too much compared to being prepared for a variety of circumstances including possible complications.


All of that criticism being said, I will reiterate that I love this book and will continue recommending it to clients, new doulas, and anyone else with the slightest interest in helping someone through labor and birth.  Penny Simkin is a legend in the doula world, and this piece is her legacy.

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