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Shelia Kitzinger is a well-known birth anthropologist and birth activist who has written a ground breaking new book. Stories of woman who have been traumatised by the maternity care system form the foundations of the book. Thousands of childbearing woman have told Shelia of their suffering when they have rung her as part of the Birth Crisis Network. The Network is a help line in Britain that women can ring if they want to talk about a traumatic birth experience. The women who ring have usually had additional suffering added by the people they had hoped would help; including doctors and husbands.

The book begins by discussing ‘Birth Shock’ which concerns how birthing has become an ordeal for many women. Women's birth experiences are considered within the context of the obstetrically dominated institutional system. How this system uses technology, time and false promises to create passive and conforming patients of otherwise independent and autonomous women is well argued.

The effects of birth trauma on the woman, her baby, her partner and her relationship with both of them are carefully considered. Following traumatic births some women experience flashbacks, panic attacks and nightmares which are symptoms of post-traumatic stress disorder. The chapter that deals with these matters can help women and midwives to make sense of these experiences as a beginning of a healing path.

For me the highlight of Birth Crisis is the chapter on Sexual Abuse and Birth. This chapter has been informed in part by the research of Shelia's daughter, Professor Jenny Kitzinger. I found the listening skills described here particularly helpful. For example, expressing anger, disbelief, blame or pity are non-helpful responses if a woman discloses sexual abuse. In contrast, reflective, woman-centred listening, where the midwife expresses calm concern or reinforces the clients control of the disclosure process are known to be helpful to women who have been sexually abused.

‘Birth Crisis’ has a strong message for midwives, GPs and child health nurses, about how to listen well. This is particularly important when woman are expressing raw emotional suffering or feeling guilty about not having behaved differently. Being a helpful listener involves giving of your self to another. It is important, Shelia reminds us, to avoid judgment, advice giving or adding to conflict. The type of listening, that traumatised women experience as helpful, involves the listener focussing on the woman, her reality, her feelings, her thoughts. The book ends with some wise suggestions about how midwives can be open to women and keep on being compassionate even in the face of their own emotions and many competing demands.

I recommend this book to women who have been traumatised by the maternity system. I strongly recommend it to midwifery students, practising midwives, child health nurses, GPs and obstetricians. The book is particularly important for midwives because so much of our work in the maternity system is implicated in causing birth trauma. Perhaps the stories of the women that are graphically told in this book will help us to become more conscious and refuse to participate in or be silent about the psychological and physical traumatisation of birthing women. Midwives can also learn valuable lessons about how to help women who have had a previous traumatic birth and now want to move forward positively.