Caesarean: just another way of birth?
by Rosemary Mander

[2007. London: Routledge, 208 pages, softcover.]

[Review first published in Midwifery Today Issue 90, Summer 2009, © 2009, Midwifery Today, Inc. Review by Elise Hansen.]

This well-organized, meticulously researched book is an important addition to the debates surrounding caesarean deliveries. While possibly of greater interest to health care professionals, Rosemary Mander has written a tome packed full of thought and research that is accessible to any reader.

Throughout this precisely organized material, Mander explains (and confronts) the data on caesarean deliveries beginning with the mythology and history surrounding the name itself passing through (in depth!) the research into caesarean, the current issues, decision-making, short- and long-term implications for both mother and baby, as well as international comparisons.

While almost apologetic about her “feminist-leaning orientation,” Mander hits the research head on, with a most rigorous perspective that she, again almost too apologetically, explains as necessary in any “stringent analysis.” That such an approach may lead to an “unevenly balanced” view only underscores her refusal to compromise her research sources.

Mander explores the use (and misuse) by the medical profession of evidence-based practice and randomized controlled trials (RCT) and, while asserting that evidence-based practice (EBP) is, in theory, a “good thing” she questions the lack of other appropriate knowledge bases (that of midwives and birthing women) and the relevance of RCT and EBP to such an individualized experience as childbirth. Mander calls, shouts, begs for more appropriate and applicable research to be done, including factoring in the birthing woman’s and her baby’s experiences, as well as taking a long, long look at the long-term implications for us all. She does not hesitate to discuss just who the beneficiary of this popular surgery might be and strongly implies that it may NOT be the women and babies it is supposed to be saving.

For a detailed, comprehensive and thought-provoking book about the current issues surrounding the caesarean debates, look no further than this one.

Reviewer Elise Hansen has been involved in women’s health care for over 25 years, has naturally birthed four children (including a footling breech), is a proofreader for Midwifery Today, academic copyeditor, a Spanish-language medical interpreter and is currently practicing as a homebirth midwife in Oregon. She still has implicit trust in gentle, non-interventive birth.

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