BOOK REVIEWS

Virginia Avenel Henderson: Signature for

Nursing edited by Eleanor Krohn Herrm-

ann. Sigma Theta Tau International Center

Nursing Press, Indianapolis, 1998, 114

pages, ISBN 0 323 00249 8.

As I read this festschrift, a collection of

international essays describing the in¯u-

ence Virginia Henderson (1897±1996) had

on the contributors, I wondered what she

would think or say as she read each word.

Knowing Miss Henderson some responses

might be anticipated, namely `in ma-

aaaaaaaay opinion'. She would have put

corrections in the margins as to what ought

to have been written, but overall she

would have been honoured by her friends,

family and colleagues both nationally and

internationally, who were invited by Elea-

nor Herrmann to contribute and graciously

wrote about her. Each author would have

received one of those many letters that will

some day appear collectively with `It was

mighty sweet of you' Fondly (or Affection-

ately), Virginia

The essays span recollections of over 70

years about her family life, her teaching

career colleagues at Columbia University,

Teachers College, New York, USA, her

work with the New England Regional

Library Association; her in¯uence interna-

tionally: in particular, the way the post-

card size ICN pamphlet she wrote titled

Basic Principles of Nursing Care in¯u-

enced nurses in the United Kingdom and

played a signi®cant role in the develop-

ment of collegiate nursing in Japan; why

she left Teachers College and then never

again taught nursing as a faculty member.

There are insights into her involvement in

clinical research long before it was fash-

ionable and an acclamation of her value of

the role of practice in the development of

nursing knowledge. Those who still search

for nursing theory through `complicated

constructs and contrived vocabularies'

may be enlightened.

Many of the authors were at Yale Uni-

versity, USA, at some time in their career

thus having contact with Miss Henderson

over a span of years. Authors who had

brief encounters with her indicate that, but

their recollection of the event is a delight-

ful, clear picture and one several people

could validate on reading about an

evening at dinner at Legal Seafood in

Boston. Friends and family remember her

life at home whether it was in Virginia,

New York City, New Haven or Gilford. The

reader learns that her life was not all

nursing and her love for social gatherings

and culinary art and food likes and aller-

gies are revealed. Concern with differences

among people, namely race and religious

beliefs, are addressed. I would love to read

the letter she wrote to Rhetaugh Dumas

when Martin Luther King died. The eval-

uation Miss Henderson wrote of her stu-

dents would be a revelation of the values

Miss Henderson held about teaching of

nursing. Those letters several authors com-

ment about from Virginia Henderson will

someday tell a story of their own.

This is an essential book for those in

nursing, and in women's studies, about a

woman born in the 19th century (30 No-

vember 1897) before the telephone or radio

were common in every home, or super

highways existed or women had the right to

vote, who searched libraries for what was

written in English about nurses or nursing

and organized the literature on index cards

that become the Nursing studies Index:

Volumes I±IV. Virginia Henderson was a

remarkable, strong willed individual; a

scholar, a leader without position power,

and a renaissance woman who wanted to be

an architect but became a nurse and helped

to design nursing in the 20th century. There

are differences in each contributor essay

but themes emerge that validate the au-

thors' perceptions. This is to be expected in

a festschrift where it was each writer's

choice as to what to include regarding the

in¯uence Virginia Henderson had on them.

Miss Henderson would have given her

friend Eleanor Herrmann (editor) one of

her big hugs for her work. I would suggest

that Eleanor Herrmann begin volume II.

The collection also offers many questions

for further inquiry.

Kathleen T. Flynn

MS RN

29 Northwood Street

Chicopee,

Massachusetts

USA

Disabled Parents Ð Dispelling the Myths

by Michele Wates. NCT Publishing,

Cambridge, 1997, 176 pages £16.50, ISBN

1 85775 250 0.

Recently, a friend of mine, after waiting

nearly 2 years for an appointment, ®nally

got to see a consultant about assisted

pregnancy. The ®rst thing that the consul-

tant said to her was to ask whether she had

really considered the consequences of

motherhood and whether she thought that

she would make a good mother. It was

suggested that she went home and thought

about what she was planning to do. Whilst

one can never be sure, and the consultant

may take this approach to all her patients,

my friend was convinced that the reason

why the consultant said what she did was

because she was a wheelchair user. It is

these prejudices that this book seeks to

overturn.

The powerful ideology of disabled peo-

ple as dependent and passive is supple-

mented by the notion that they must be the

cared for rather than the care-givers, that

they are unable to raise a family and must

therefore be denied reproductive rights.

Much recent research around disabled

parenting has focused on the child, seeing

them as the `care-giver', almost suggesting

that disabled people have children purely

to exploit them. It ignores the fact that

disabled parents, on the occasions that

they have to rely on their children as

carers, do so not because they wish to, but

because society has failed to provide them

with adequate social support. They also

suggest that this is an everyday occur-

rence, that a child of a disabled parent is

denied any childhood.

This accessible, informative and enjoy-

able book, documents and explores the

experiences of disabled parents. Written

by a disabled parent, and from the per-

spective of disabled people, it avoids

many of the pitfalls so often found in

writings on disabled people. It neither

vili®es nor glamorizes disabled parents.

Indeed the title of the ®rst chapter, Not

Another Book About Heroines, clearly sets

the tone. Written from a disability rights

perspective, this book shows how many of

the problems faced by disabled parents are

Journal of Advanced Nursing, 1999, 29(3), 764±769

764 Ó 1999 Blackwell Science Ltd

not the result of their impairment, but a

consequence of a society that is organized

to exclude them. What this book also does

is provide people with strategies to chal-

lenge this social exclusion. It is both

positive and practical. Wates has pro-

duced an excellent book that will be of

interest both to professionals working in

the area and prospective parents. It is one

that I would highly recommend, and

would suggest that it should be on reading

lists not just for midwifery courses but for

any professional working with disabled

people. It would also be a valuable re-

source for any disabled person considering

parenthood.

Nicholas Watson BSc MSc

Department of Nursing Studies,

University of Edinburgh,

Edinburgh,

Scotland

Fetal Awareness: Report of a Working

Party. The Royal College of Obstetricians

and Gynaecologists. RCOG Press, London,

1997, 28 pages, £6.00, ISBN 1 900364 07 7

The subject matter of this report concerned:

the fetus's awareness of pain; the gestation-

al age (GA) at which this might develop;

whether it is in the future interests of a

surviving baby to attempt to alleviate fetal

pain; and the implications for diagnostic

and therapeutic procedures carried out on

the fetus, and for the termination of preg-

nancy. The report will be of considerable

interest to all concerned with the well-

being of parents and fetuses. It is well

written, accessible and well balanced and

lays out the boundaries of its considerations

clearly: perhaps too clearly, avoiding the

ethics of late abortion and the contentious,

fascinating concept of consciousness,

merely accepting that `awareness is a corti-

cal phenomenon'. The review of the evi-

dence for necessary, but not suf®cient,

conditions for cortically subserved aware-

ness of pain at 26 weeks GA, was relatively

convincing. It should serve to reassure us

that fetuses experiencing intra-uterine pro-

cedures, miscarried, or aborted in the ®rst

trimester of pregnancy, do not suffer. How-

ever the conclusions reached about precise

age at which the perception of pain deve-

lops may be premature.

Given the working party's principle that

`the fetus should be protected from any

potentially painful or harmful proce-

dures', it seemed surprising that they

should only recommend that the use of

analgesia be considered for fetuses of 24

weeks or older involved in diagnostic or

therapeutic procedures. But given how

little we know about the effects of drugs

on the developing brain, their caution is

understandable and their arguments infor-

mative. It is to be hoped that the research

which they recommend will clarify these

effects, since caution over analgesic side-

effects has all too often allowed patients to

suffer pain which could be safely alleviat-

ed. For many readers the most contentious

section of the report concerns the recom-

mendations about the fetus who is not

expected to survive. It clearly demon-

strates how modern anaesthetic practice

during late terminations does not meet the

analgesic needs of the mother and fetus

simultaneously. The working party recom-

mends that terminations of pregnancy

performed at or beyond 24 weeks GA,

should involve either feticide, to stop the

fetal heart rapidly, or premedication, given

to the mother so as to sedate the fetus.

Such terminations are only legally permit-

ted for serious fetal abnormalities and are

rarely carried out. The possibility of intra-

uterine suffering which the recommenda-

tion raises is, however, deeply disturbing

and has implications beyond surgical ter-

mination, for instance for the ill or abnor-

mal fetus.

I found the logic of their argument for

feticide or fetal sedation, in cases of

late termination, sound and profoundly

thought-provoking. I was less persuaded

by their discussion of fetal stress and was

concerned that the maternal distress

which may be exacerbated, or relieved, as

a consequence of their recommendations

was ignored. However, such reservations

do not stop me recommending this report.

It is an important report with far reaching

implications for nursing and medical eth-

ics. All nurses and midwives involved in

the care of fetuses will ®nd it fascinating,

and, properly, troubling.

Catherine A. Niven

RGN BSc PhD

ProfessorofNursingandMidwiferyStudies,

Department of Nursing and Midwifery,

University of Stirling, Stirling,

Scotland

Midwifery Practice: Core Topics 2 by Jo

Alexander, Valerie Levy and Carolyn

Roth. Macmillan, Basingstoke, 148 pages,

£14.50, ISBN 0 333 69627 1.

This is a further addition to a series of

edited midwifery texts with a research

focus. As such this book may represent an

example of a trend in health care publica-

tions and it may demonstrate the way in

which midwifery text books are likely to

develop in the future. The ®rst three books

in the series adopted a slightly medically-

oriented chronological approach to issues

in childbearing. They focused on antenatal,

intrapartum and postnatal care respective-

ly. Since those original publications the

focus of the next three has become some-

what blurred. In spite of this, the topics

which are addressed are crucial to mid-

wives and to midwifery practice. The con-

tributors' authority, however, is variable, as

is the standard of their contributions. This

most recent volume provides apposite ex-

amples of these observations. The topics

included tend to focus rather loosely

around labour, including emergency situa-

tions, second stage care and the third stage.

How diabetes mellitus in pregnancy and

the anthropology of motherhood ®t in to

this framework, though, is less than clear.

In terms of the contributors to this book,

a small number are well known, such as

Rona Campbell and Rona McCandlish.

Some contributors are becoming well-

known, while others are new to this read-

er. The quality of the contributions also

varies. The chapter on place of birth by

Campbell is authoritative and identi®es

the essential issues clearly, adopting an

appropriately serious academic approach.

Bewley contributes a challenging chapter

on a well-de®ned group of pharmacologi-

cal forms of pain control ± the injectable

methods. McDonald's chapter on active

management shows a healthily critical

approach to this dogma, but the precision

ordinarily expected of academic authors

shows occasional lapses. The feminist

perspective on care in labour by Bates

has few pretensions to academic objectiv-

ity, but represents a provocative and easily

readable critique of current obstetric and

midwifery practice. Despite or possibly

because of these observations, the material

is invariably stimulating. I look forward to

using all of this book with undergraduate

students, who are likely to be as enthused

as I am by the refreshing approaches of the

contributors.

Thus, this volume comprises an eclectic

and perhaps even slightly idiosyncratic

collection of material. It may be feasible to

identify a theoretical framework which

Book reviews

Ó 1999 Blackwell Science Ltd, Journal of Advanced Nursing, 29(3), 764±769 765