Carole Osborne-Sheets should be commended for Pre- and Perinatal Massage Therapy, This book is an excellent addition for massage therapists working with women in their childbearing years. She has pulled together a tremendous mass of information and has coherently framed it inot a comprehensive overview of important concepts. It is clear from the outset that Osborne-Sheets has the well-being of childbearing clients foremost in mind, and this work indicates an appreciation of the need for a holistic attitude that considers the physical, emotional, and aspiritual aspects of a woman's experience during this life-changing time.

The book begins by addressing the benefits of prenatal massage. Osborne-Sheets has included an impressive array of data and excellent resources to support what those if us working with childbearing clients know- that bodywork is beneficial for pregnant, laboring and postpartum clients. Since research has become an increasingly important means for supporting our work, the reader is reminded to pursue some of the resources mentioned while maintaining the attitude toward critical analysis of each study examined.

Perhaps the most important section of this book is the second chapter, "Guidelines and Precautions for Prenatal Massage Therapy." Osborne-Sheets adopts a valuable, conservative approach to guidelines that underscore the motto "Do No Harm." This is an attitude that any practitioner dealing with the vulnerabilities of pregnancy could benefit from adopting. Her coverage of positioning, depth of pressure, and usage of particular methodoligies and their possible effects on the pregnant client are very important to understand, and she clearly cites the rationale for each consideration mentioned.

The third chapter delves into each trimester with specific information about the anatomical and physiological changes that occur, and the techniques and approaches that will maximinze bodywork for that particular time of the pregnancy. The fourth and fifth chapters address issues related to labor, brith and postpartum bodywork.

Photographs, charts and diagrams serve to augment the infromation cited in each chapter, and offer clear summaries for quick reference. Additionally, Osborne-Sheets gives excellent tips with respect of particular bodywork applications.

With respect to the continuing development of pre- and perinatal bodywork, there are several ares of the book which warrent further collegial dialogue. There is no mention in the section on contraindications and adaptations about utilizing bodywork over the sacrum and possible concerns regarding reflex stimulation of the parasympathetic nervous system. The application of bodywork techniques in this area is especially important to consider when working with clients who are in their first trimester or who fall into high-risk categories due to obstetrical complications. Also, the information on leg massage for the childbearing woman and the possible risk of clot formation warrents special attention, particularly when working with clients who are on prolonged bed rest.

For practitioners wishing to gain new insights into their work with childbearing women, or for those who have been hungry for a well-orchestrated text on the matter, this book is excellent. Osborne-Sheets helps provide a foundation of information that can oly further the work we do within the pre- and perinatal clinical setting.

Cindy NcNeely is a registered massage therapist and co-owner of Trimesters: Massage Therapy Education, which overs accredited courses in pregnancy, labor support and infant massage. She also supervies a perinatal hospital-based massage therapy program in Toronto, Ontario, Canada.

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