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.
It was only when reading this book that I reflected back to my daughter's birth 12 years ago, prior to which Ina May Gaskin's book Spiritual Midwifery had been my constant companion. Ms Gaskin reflects that so often for women in the civilized world, stories of births from friends and relatives are usually filled with intervention and problems. In my friends only one had a trouble free and easy birth - she went into hospital at 4am, gave birth at 6am and left the hospital at 9am. Other women had 28 -40 hour labours, caesarian's, inductions, forceps. I realised how true it was that we are surrounded by more stories of negative birth experiences, than positive ones. Reading Ina May's books you are immersed in stories of women who had positive birth experiences where they were surrounded by people who loved them, people who had been through the birth experiences successfully themselves and who, even in cases of previous ceasarians, twins births, breech births -which would normally require hospital intervention, gave birth normally and naturally without drugs or surgical intervention. A quick flick through hospital statistics shows that large hospitals have a much lower rate of normal births - about 40-60%(ie without drugs or intervention) than do smaller maternity units and community hospitals (with 90-100% natural births). Many commentators suggest that hospitals intervene too quickly when labour doesn't proceed quickly enough, - even to my dismay noting that some hospitals will now insist on drug induction when a woman passes her due date - when it used to be that the woman was allowed to proceed to 2 weeks post due date before induction. I cannot stress how highly Ms Gaskin's books moved me and how much I feel they have helped me in my own labour experiences. If you read only one book during your pregnancy - read either one of these two books.
on 16 August 2004
Ina May is a real person, a real mother, a real midwife. She makes physiological information about birth clear while mixing in a bit of medical history, anthropology, humour and extra-ordinary stories of birth from ordinary women. "Let your monkey do it" is Ina May's advice--in other words leave your socialization and high level reasoning behind--for finding the right place, time and way in which to birth your baby. Ina May respects women, babies, partners and other care providers who may or may not share her beliefs about birth. Enjoy this informative read.
on 10 July 2014
Even if I didn't agree with everything in this book, I found it greatly encouraging and feel a lot more confident and less fearful about giving birth. That said, I can see how some people can find aspects of this book more scary than helpful. I feel very fortunate that I live in the UK, where the midwifery model is practised, and where a lot of the things that Ina May advocates (active birth, eating and drinking while in labour, skin-to-skin contact, a home-like environment, etc) are standard practice, even in hospitals. Providing that you're having a low-risk pregnancy, you have a choice of giving birth in a hospital, at home or in a birthing centre--even if you're a first-time mum--and you'll be attended by NHS midwives in each situation. Even in hospitals, water births and aromatherapy are available for use, and gas and air (the one form of medical pain relief that Ina May seemed to approve of) is available at all births. Basically, I was already well on the way to having an Ina May-style birth long before I even picked up this book.
That said, some of the birthing stories in this book were a little too hippyish, even for me. Even if there were some stories that made me shake my head and think, "Even if I'm desperate, I'm not sure if I could try that", it was encouraging to read so many stories from women who wanted to share their birthing experiences. Since most of these stories took place in homes or birthing centres, I found it encouraging to be continually reminded of the importance of a comfortable, relaxed environment, and being surrounded by people who share your hopes for that type of birthing experience. The main reason my husband and I are hoping to have a home birth is because it seems like the most relaxed, stress-free option for us.
I enjoyed reading about the different midwifery techniques Ina May had learned over the years, either from historical accounts of midwifery, or from doctors who supported her work, or personal experience. In particular, the need to be active and upright during labour, and the power of breathing and listening to your body's signals. Although these weren't always entirely new points for me, they delved deeper than what I'd read previously or learned in antenatal classes.
Ina May is definitely sceptical of a lot of typical practices in US hospitals, and for the most part I agreed with her--particularly on issues such as banning labouring women from eating and drinking, or routine IVs and foetal monitoring, even on low-risk women. There were some things that I know I'll have to research further, simply because Ina May doesn't back her opinions up with medical facts. For example, she talks about the dangers of medical inductions using various methods, and I'm not 100% sure which method is most commonly used in the UK (although I know that you can refuse induction, and that UK midwives prefer to start with very non-invasive methods such as membrane sweeps). She also seemed bizarrely worried about the risks of ultrasounds, but given that this book was first published over ten years ago, perhaps more is known about their safety now? The other issue I disagreed with her on was Vitamin K shots, which as far as I'm aware, pose no disadvantage to the child--but again, perhaps we know more about this now.
There were several points where I had to pause and read a paragraph out to my husband, followed by a relieved, "Well, I'm very glad we live in the UK." I can definitely see how this book could make some women fearful, especially those living in the US who have no option but to have a hospital birth assisted by a doctor rather than a midwife. I think Ina May advocates for some great ideas, but for those women who don't have a lot of options, the facts presented in this book could make them feel more scared than encouraged about labour. That said, this book doesn't appear to have been updated since its 2003 release, and I hope that care for pregnant women in the US has improved since then. I've got the impression from friends in the US that birthing centres are becoming more common, and that more women are opting for natural births and water births. It still seems a little bizarre that the two most common non-invasive forms of pain relief (TENS and gas and air) are relatively unpopular in the US, even now. Ina May doesn't even mention TENS in her book, but I'd be interested to hear her thoughts on it.
Ultimately, this book encouraged me to approach my labour with a positive attitude and confidence that my body is made to carry and give birth to a child. Even if there are some techniques in this book that I probably won't be trying, I'm going to aim for a relaxed, comfortable environment and to follow my body's lead. My husband and I have already made a list of techniques to try in early and late labour, both to keep my mind from running away with worries and to help labour progress. If this is the kind of birth you want, and know that your health care provider will allow, then you'll probably find this book quite helpful. If there's anything that worries you or that you're sceptical about, it's probably worth doing further research, given that Ina May doesn't always back up her points with medical facts, and that some of the statistics are ten years out of date. It's for this reason that I'm docking half a star and rating this book 4.5*. Overall, an encouraging and fascinating read, even if not all of it was relevant to our situation.