L'Mazeltov Your Personal Guide to Jewish Childbirth Education By Pamela Nadav Published by L'Mazeltov 248 pp. $18 This is an attractive book with simple layout and neat line drawings. If intended for a wide readership, including the Orthodox community, it is appropriate that there are no graphic pictures. L'Mazeltov is described as a creative integration of traditional childbirth education with an introduction to Jewish life, traditions, values and philosophy especially for Jewish expectant parents. However, unlike some of the home-grown books written here for traditional or Orthodox English-speakers, the writer seems to be addressing a far less knowledgeable reader. She makes it clear that this book is not intended to replace attendance at a childbirth education course, but the information presented is very superficial and in some cases the language is dumbed down. There is a strong focus on the physical changes and symptoms in pregnancy, procedures and tests, danger symptoms, signs of labor, what to take to the hospital, but little on perinatal attachment or the sensitivity of the father except as a labor "coach" or "buddy." Incidentally, I do like her reference to the labor "buddy" because not all women have husbands or male partners and many women, not only the Orthodox, prefer to have female support during labor. The Jewish connection is what makes this book different from others. It is very useful to read of the traditional foods that promote fertility, the value of the family table, the psalms and prayers and rituals connected to childbirth but this is detracted from by filling out the book with a definition of the festivals, complete with recipes. While providing definitions of life-cycle events such as brit mila, bar and bat mitzva, an opportunity is missed to actually address some of the questions of the traditionally observant. For example she recommends waiting to start sex after childbirth until the lochia has finished, but does not explain the laws of nidda. The book is culture bound in that it is obviously for the Diaspora readership. The suggestion to create mother support groups within the synagogue is very useful when a new parent is trying to find friends within the community. In Israel, it is more of a problem for immigrants to meet up with parents with a common language and ideology. After all, the coffee shops at the shopping malls are packed with Jewish parents. The author is an experienced maternity health worker and childbirth educator. She lives with her family in California and has created a professional outreach program with the same name as the book. But her approach and methodology are sometimes outdated. Although controlled breathing is still an integral tool, we don't teach all the Lamaze huffing and puffing today. She also recommends "changing positions" every 30 minutes during labor, whereas the modern approach to active birth is to keep moving, spend time in the bath or shower, use massage oils and other alternatives such as shiatsu, guided imagery and music, and avoid lying in the bed for long periods. The difference in health systems is also apparent because whereas in the US a pregnant woman can refer to the same obstetrician who will attend her during the birth, here there is no connection between the professionals who give pregnancy care and the staff of the maternity ward. Reviewing my case histories, the level of satisfaction expressed by women after the birth is often determined by the support of the attending midwife rather than the doctor who was in the background. While responsible childbirth educators recommend that the laboring woman and her supporters work as a team with the midwives and doctor, the feeling when reading this book is that the power is taken away from the woman. The modern Jewish woman here or abroad would not expect her doctor to decide for her whether to take pain relief and whether she should lie down or sit up. There are a few errors along the way, for example the definition of pre-eclampsia and normal blood pressure readings. And some of the hospital routines are outdated. Examples are artificial rupture of the amniotic sac at two to three centimeters, induction of labor for multiparas "to prevent precipitate labor." We assume from the author's description of hospital routines that there is continuous monitoring which is now not routine for low-risk births and that might explain the absence of reference to walking about during labor. The author does not question that in 2004 in the US the cesarean rate was 29.1 percent (in Israel it is creeping up to 25%), whereas the World Heath Organization recommends that it should be 10%-12%. When describing pain-relief drugs, there is no reference to the disadvantages as well as the advantages of the different methods. There are also some outdated tips on breastfeeding such as toughening the nipples with a dry washcloth. That the baby should feed more during the day so that "he will sleep better at night" does not concur with the modern approach to baby-led breastfeeding. There are good points in the chapters on postnatal care, reinforcing the importance of "mothering of the mother." But while it is true that the eighth day for the brit mila is the optimum time in terms of the baby's blood-clotting ability, evidence shows that it is not true that babies feel less pain at that period. The book would make a nice gift, but with it I would recommend giving a voucher for a childbirth education course. The reviewer is a childbirth educator and breastfeeding counselor, honorary president of the Israel Childbirth Education Center, author of Life After Birth - Everywoman's Experiences of the First Year of Motherhood and the anthology The Soldiers' Mother.