One of the very few stipulations my wife made after we learned we were going to have a child is that I read this book by the doyenne of natural childbirth in the U.S. While the tone of the book is much too touchy-feely/hippyish for me, I have to admit that it is well worth reading regardless of whether you're planning a natural childbirth or a fully tech'ed out hospital one. That said, it would be very easy to read it as gospel and get swept up in its giddy repudiation of modern medicine, so one should approach it with, if not a skeptical eye, at least with one's critical faculties fully engaged. There is also the potential that readers who are fully committed to a hospital birth may come away from this book feeling scolded, or as if their decision is somehow "wrong".
The author is a superstar in the field of natural childbirth, largely as a result of her 35+ years work at "The Farm", a kind of birthing commune in Tennessee. The first half of the book is a compilation of natural childbirth stories written by mothers who've either done it at The Farm, or somehow in conjunction with the author. While these are certainly useful as illustrative examples of how it all goes down, they tend to get rather repetitive and could certainly stand to be scaled back a bit. And for those who know little about the birthing process, some of the terminology can be unclear. Finally, for those who might want to read this book on the subway (like me), be forewarned that there are some pretty graphic photos of childbirthing in this section.
The second half of the book walks the reader through the entire process, mostly with the aim of explaining why modern medical childbirthing procedures are not based on the mother's health and needs, but are designed for convenience of the medical establishment. Stuff like epidurals, amnios, fetal monitoring, pitocin, forceps, vacuum extractors, etc. all come under sustained assault. Gaskin makes a convincing case for most of her criticism, with plenty of good examples from historical texts and anthropological research. Perhaps the most striking and compelling examples come from studies of childbirthing in modern Scandinavia. Sometimes Gaskin stretches a little to far in her attempt to debunk every single medical procedure and doesn't always have the most current data. For example, Rhogham does not have any mercury whatsoever any more, and the danger from amniocentesis is vastly overstated. However, simply in terms of the debate over natural childbirth vs. hospital birth, it's awfully hard to argue with the data she's gathered from thousands of natural childbirths.
Ultimately the reality is that every mother's experience is different, and there's no technique, approach, or solution that works for everyone. That said, the book did a pretty good job of convincing me that the mother's mental approach to childbirthing and expectations for the experience are the single most important indicator of how it will all go.
I'm 17 weeks pregnant, and while I'm overjoyed to be pregnant...I've always been afraid of the pain I'll experience during childbirth. Reading Ina May's book, and the birth stories of the women in it, has changed all of that. I feel that I can handle labor now...and am even toying with the idea of not using drugs. (Prior to this, I used to say that I'd like an epidural plus any other drug they'd give me.) Even if I end up using some pain meds, I know I'll be entering the labor process without the level of fear I had before. That is priceless. This is a must-read for any pregnant woman and her husband...whether or not she wants to have a medicated or non-medicated birth. Bravo Ina May! Just wish I lived closer to TN so that I could use her services.
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Anyone associated with the childbirth genre knows of Ina May, and her many devotees have been waiting a long time for this book. It couldn't have come at a better time, as legions of today's women voluntarily turn to the tricks of modern obstetrics, notably epidemic epidurals.
I'm a retired midwife (and author of Baby Catcher, a modern midwifery memoir), and feel I learned a good bit of my craft by listening to Gaskin speak, visiting The Farm a bazillion years ago, and reading and rereading and rereading Spiritual Midwifery. But much in obstetrics has changed since Spir. Mid. was published; at that time, natural childbirth was all the vogue, and Ina May was sort of preaching to the choir. Now, oh lordy, now things are very, very different. Cesarean rates hover around 25-30% in some hospitals, and the epidural rate is twice that. What are these women thinking??
It was by studying Ina May's 'style' that I realized the power of teaching by parable: the power of story-telling. Women's eyes glaze over when they're lectured to, but their attention is rivited by birth stories. In this Guide to Childbirth, Gaskin deals with the changes in modern OB and offers ways to get around the routines. But she once again relies on her story-telling techniques for getting across her central message: If you're surrounded by people who believe you can do it and who support your own belief that you can do it, then guess what? You can do it.
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I am related by marriage to a midwife, so I have heard the gospel of homebirth for years. But the books she lent me had publication dates from my grade school and junior high years, so I often sneakily wondered--is it still really that bad? Then I started prenatal visits for my own first baby, and yes, it pretty much is. I am going to a doctor to keep an eye out for conditions that would call for the resources of a hospital--but if there aren't any, I'm staying home to have this baby. Read this book and you may decide the same thing.
Without scare tactics, and with plenty of solid data to back her up, Ina May provides a timely antidote for the overly mechanical, overly pharmaceutical way of childbirth that is still the conventional wisdom in most U.S. hospitals. She makes the chilling point that a lot of so-called necessary medical procedures--procedures that can increase the stress and dangers of childbirth--are based on modern physicians' ignorance of how birth really works. Ina May quotes from medical texts written before many of the drugs and procedures now used in "routine" hospital births were invented. The doctors who wrote those old books did something most modern obstetricians have never done: they observed normal births, over and over and over. They took for granted things that have been forgotten by modern medical schools. Ina May combines this old medical model of childbirth with her own vast experience in midwifery to guide you through what really happens during labor and what you (you plural--Mom *and* Dad) really can and should do.
Ina May will steer you safely between the artificial terrors of modern obstetrics and the artificial transcendentalism of many pregnancy handbooks. Her common-sense advice will help you sleep at night and click on a lot of light bulbs over your head. You will close the book feeling the truth of Ina May's pungent closing line: "Your body is not a lemon!"
UPDATE--JULY 2006: I've given birth twice since I wrote the above review and I still stand by every word. Whether you plan to give birth at home, in a birthing center, or at a hospital, take a childbirth education class for the basic details of the birth process--but read this book to fill in the inevitable gaps.
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This book helped me change my life.
After the necessary c-section birth of my son 5 years ago (I had pre-eclampsia), our new insurance company labled me as "high risk" and refused me maternity coverage. Since my husband and I wanted more children, I started considering a home birth with a midwife as a viable alternative. Needless to say my first birth experience put me emotionally on guard about my body's capability.
As I was researching the safety of VABCs (vaginal birth after cesarean) and home-births, I came across Gaskin's 1970s book, Spiritual Midwifery. Its language was amusingly "hippy-ish," but the inclusion of positive birth stories was refreshing and inspiring. After reading most of it, I went in search of similar, more updated books.
I found Ina May's Guide to Childbirth at a mainstream bookstore (being suprised at the lack of variety of birth experience offered on the shelf is she the only person writing about homebirth nowadays?) Buying and reading this book new was one of the best emotional investments I have ever made in my life.
The experience and knowledge I gained reading this book is similar to many of the sentiments expressed in these other reviews. It really gave me courage to welcome and joyfully (if a little nervously) anticipate the birth of my daughter in March of 2005.
As for my labor, I would not call the sensations of the contractions "pain," I would call them "very heavy pressure." I credit this perspective to this book. Ina May (and her clients) helped me put contractions, transition, etc., into perspective. For example: Yes, I felt contractions every two minutes lasting about two minutes. No, it wasn't comfortable, and I had to concentrate and breathe through them with my eyes closed, hanging on to a door jamb. After two minutes the pressure went away for a while, during which I could laugh at my husband's jokes. Nature is pretty smart, giving women short "rest periods," as this book tells (reminds) us!
Reading about other women's experiences of physical sensations during their labors gave me a range of ideas as to what to expect, so as my own birth story was unfolding, it wasn't so scary or mysterious.
I am so grateful for the VBAC home-birth experience I had thanks in many ways to this book's writer and contributors I was beaming for days afterward! It was the hardest, most challenging thing I've ever done (notice I did NOT say "painful" or "scary"), and I was so proud of the outcome. My husband is still in awe of the power of my body!
An armload of gratitude to Ina May and her colleagues, the work they do, and the brave women who seek her out and share their experiences. I look forward someday to the home birth of my third child, knowing I am as strong and capable as the women who share their stories and wisdom in this book.
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I have just ordered Atwell's book, the second one I will own and know I will treasure. I am a far-flung fan of his columns in the Cooperstown Crier. He is a local treasure himself and I look forward to sitting back by the fire and reading more of his wit and wisdom.
