Effective Care in Pregnancy and Childbirth

It is rare for the editorial columns of a journal to draw attention to, or to review a book, hut then it is also rare to have a book which merits such a notice. Effective Care in Pregnuncy and Childbir/h, edited by Chalmers, Enkin and Keirse, is probably the most important book in obstetrics to appear this century and its value to the profession will be profound and long lasting. Twenty years ago that wise physician Richard Asher (1972) wrote: ‘We always say “What is the treatment o j thi-s disease?” rather than “Is there ~i Ireuhient for this disease?”. Evetz the expression “effective treatment” is a quaint one . . . Logically we sharrld not give treatment unless i1 is effective. ’ He was driven to conclude that. ‘It is better to believe in therapeutic nonsense, than openly to adniit therapeutic bankruptcy find thi5 one of the rnost uncomfortable concepfs that logical reasoning leads me to. f fyou admit t o yout-sey that the treatment you are giving is frankly inactive, you will inspire little confidence in your patients unless y o u huppen to be a remurkably gifted actor, and the resiilts of your treatment will be negligible. But If you believe ferIwitly in your treatment, eveii though controlled