Preventing and Managing Back Pain During Pregnancy.

Preventing and Managing Back Pain During Pregnancy Silva AM. Norwood, MA 02062, Expect Fitness, 2004, paperback, 116 pp, illus, ISBN: 0-9755826-2-3, $14.95.

This is a simple, well-written, and easy-to-read book that addresses the important concept of using a safe exercise program during pregnancy to help minimize back pain.

The book is divided into 13 chapters, which fall into natural groupings. In the introduction, the author urges her readers to start with the first 5 chapters, which cover basic anatomy and physiology and the causes of back pain in pregnancy, before applying the exercise protocols that come later in the book. However, the author advises the readers who do opt for the exercises immediately to eventually read the earlier chapters for a better understanding of the programs.

Chapters 6 to 10 cover the basics of the exercise programs, with a chapter each for cardiovascular training, strength training, stretching, and posture and body mechanics. These chapters are well written and illustrated with clear black-and-white drawings that appropriately depict a pregnant woman and do not glamorize the image.

The final group of chapters opens with a discussion of management of postpartum back pain. Chapter 12 then recommends a set of 11 daily programs, none longer than 30 minutes, for the reader to follow during pregnancy and after birth. These include specific guidelines for each trimester, the early and later postpartum periods, and more specific programs, including exercises for pain in various locations and for acute pain and a 10-minute program. The book ends with a chapter titled "Author's Notes," in which the author summarizes the main points of the book. This is followed by a comprehensive and easy-to-use index.

Overall, this is a very reader-friendly book. The organization is logical and easy to follow, with clear directions from the author on how to locate specific issues in the book. References are cited on the same page so that they are easy to find but do not interrupt the flow of the text. References include peer-reviewed articles that support exercise during pregnancy. The anatomy diagrams are clear and well labeled, and each chapter concludes with a paragraph that concisely summarizes the main points of the chapter.

One of the greatest strengths of this book is exercise descriptions. They are concisely and accurately mitten, and can be followed easily. Many of the individual exercises are offered in several positions so that the reader can find the one that is the most comfortable. There is regular encouragement to seek advice from health care professionals if the reader has questions or concerns.

This is a text that should be recommended to all women considering pregnancy or already pregnant as a reference source and exercise guideline. It would serve as an excellent reference for students or for new graduates entering the women's health arena or encountering pregnancy-related back pain in the outpatient department. It also would serve well as a reference book in all women's health and outpatient clinics.

Christine Childers, PT

University of Utah 

North Salt Lake, Utah 

Ms Childers has worked extensively in women's health in the United Kingdom. Since settling in Utah, she has worked at various skilled nursing facilities in the Utah valley and is currently working at the University of Utah inpatient rehabilitation unit.