Midwifery Today, Issue 148, Winter 2023
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Within the Pregnant Pause, by Amali Lokugamage. (London: Docamali Ltd, $15.96, 60 pages, paperback.

Within the Pregnant Pause is an inspirational, thought-provoking, and graciously simple book by Amali Lokuamage, MBChB, BSc, MSc (Epidemiology), MD, FRCOG, SFHEA. Every page turn is illustrated with beautiful artwork by Clare Rayner. Like a mini-coffee table volume, the book is designed for pregnant women and their supporters. It would also be an excellent addition for any midwifery or obstetrical office to be perused by waiting clients.

The author is a consulting obstetrician in a London hospital where she works closely with midwives. Dr. Lokuamage is a longstanding board member of the International MotherBaby Childbirth Organization and has been supporting the worldwide implementation of the International Childbirth Initiative, now in over 75 countries. Her special focus is on human rights in health care and equality, diversity, inclusion and decolonization in medicine. Her previous book is the popular pregnancy book, The Heart in the Womb.

Within the Pregnant Pause consists of 27 separate topics. Each topic explores some aspect of pregnancy and birth with a broad emphasis on the value of stillness, nurturing, and looking within. It also includes “the four Ps” and oxytocin physiology, as well as commentary on preparing for a natural birth, cesarean, and complications. The volume lightly touches on each of its topics. For instance, the “Medical versus Social Model of Birth” page says:

• Never underestimate the power of humane care on health
• Childbirth is a psychobiological state
• Natural childbirth is an opportunity for the amplification of oxytocin physiology on individuals and its effect on society
• Bonding helps neurodevelopment

The above is illustrated by a deep blue painting of a woman holding a child.

Written during the Covid-19 pandemic, the book provides ample opportunities for self-reflection and the value of being at peace within pregnancy. The illustrations also call for calmness and quietude. Their soft, rich colors partner with the words on each page and are harmonious with the meanings of the text. It would be a great resource for women in their sometimes chaotic experiences during pregnancy.

Another section focuses on “If You Are Aiming for a Natural Childbirth.” The book suggests:

The hormonal orchestra and your muscles and sinews can be prepared by some of these:

• Accessing deep relation
• Continuity of care with trusted relationships
• Circles of supportive women
• Yoga
• Mindfulness
• Hypnosis

This page is accompanied by artwork showing a woman birthing her baby into her hands.

Within the Pregnant Pause has many strengths. It is a calming, thoughtful blend of ideas and art meant to inspire the woman as she carries her baby. Its weakness, if any, is that it can leave one wanting more—more insights and information and perhaps a bigger volume.