BOOK REVIEW / Happy birthday to you, and you: Ourselves as mothers - Sheila Kitzinger: Doubleday, pounds 16.99

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The Independent Culture
HERE is a book for the floundering new mother who suspects but cannot prove that her problems are not all hormonal - as her husband, her doctor and maybe even her mother will have been suggesting.

Though dressed up as a popular anthropological survey of mothering, and designed and illustrated to sit prettily on the shelf next to Penelope Leach and Alex Comfort, its aim is to undermine the authority of all doctors who think they know best and of all childcare prophets who would have us believe that there is only one good or safe way to bring babies into the world. 'There are,' it argues, 'many possible permutations of the mothering role. No one is universally right . . .'

Sheila Kitzinger is careful, respectful and encyclopaedic in her celebration of diversity. She tells us about pregnancy, birth and childcare past and present, in all types of social conditions, and under the influence of all the major religions and political philosophies. She explores the almost universal fears about female sexuality and the pan-cultural reverence for these same women if and when they manage to bear children. But her chief interest and target is our own overdeveloped West, or more specifically our medicalisation of birth and the systematic degradation of mothers.

These are not new accusations. What makes this book different is that it applies the anthropological method to our own culture. We are accustomed to thinking that all hospital practices are 'scientific'. Here she shows us that while some hygiene measures are empirically based, others are purely ritualistic. Sterile clothing, for example, is de rigueur for almost all hospital staff attending a birth - except for the senior obstetrician, who is allowed to wear a different costume, a suit, until and unless he has to touch the patient.

'In childbirth,' she says, 'obstetricians act as our own tribal leaders controlling a perilous life passage. The mechanisms by which women are conducted through this transition to motherhood result in their feeling safer when undergoing these processes than when they are not performed.' But because they also depersonalise a woman and rob birthing of the social and cultural meanings it used to have, they launch her into motherhood feeling disoriented, overwhelmed, doubtful of her own judgement, and therefore easily controlled.

Though it is gratifying to see in print the complaints parents make in private, and though Kitzinger is right to say that birth and motherhood are political issues that must be addressed at the structural rather than the personal level, her picture of everyday late-20th-century motherhood is perhaps a little too dreary. Looking after children at home can be isolating, but after an initial rough patch most women manage to build up a network of supporting friends that is as good as any network to be found in Jamaica or West Africa.

As for the big bad NHS, certainly we should be lobbying it constantly, but not all hospitals are as deplorable as the ones she describes, and not all invasive obstetric procedures are totally useless. The point is not to do away with technology altogether, but to use it only when needed and with respect for the woman's feelings. I wish she had devoted some space to the innovative programmes that have used her own works as their inspiration, and I would have welcomed a short tribute to those of us who, though degraded and depersonalised, isolated and underpaid, have come through motherhood with enough presence of mind to appreciate a book like this.