INA MAY’S GUIDE TO CHILDBIRTH, Ina May Gaskin

This is a must read for every pregnant woman. There isn’t much I can say other than that. It was the first book I read when I found out I was pregnant. I did a search of the books about birth at my local library and this was one of two or three that came up. A “Guide to Childbirth” seemed like a a good place to start my preparation for childbirth.

I have had a few friends read this and tell me that it is so empowering and that they felt more than ready to have their baby after reading it through. Those reviews are a testament to both the content of this book and Ina May herself. She is not called the nation’s leading midwife for nothing. I’ve seen her interviewed a few times and her confidence about a woman’s ability to birth her baby naturally can put almost anyone at ease. That confidence, that is based on knowledge and experience, comes through in the pages of this book. You believe her when you read that childbirth does not have to be approached with fear. You believe her when you read that your body knows what it needs to do to manage pain and progress during labor. And, if you are me, you will read about her “Sphincter Law” and believe that it is the key to a successful natural, vaginal birth. Then you will proceed to practice it in the bathroom when faced with the seemingly inevitable constipation that hits pregnant women.

In case you are pregnant and don’t read this book, I am going to give you a short summary of Sphincter Law because I think it is imperative that you know it before labor.

• Sphincter: a circular band of voluntary or involuntary muscle that encircles an orifice of the body (anus, vagina, cervix) or one of its hollow organs.
• Sphincters do not obey orders, like PUSH!
• Sphincters function best in an atmosphere of familiarity and privacy (ever try to poop in front of people? or on vacation?).
• Sphincters may suddenly close when their owner is startled or frightened. This is part of our natural flight or fight response.
• Laughter helps open the sphincters (ever laugh so hard you peed your pants?).
• Slow, deep breathing aids the opening of the sphincters
• Immersion in water helps because it is difficult to hold you muscles still and rigid while in water.
• A relaxed mouth means a more elastic cervix. Ina May has observed that “women whose mouths and throats are open and relaxed during labor and birth rarely need stitches after childbirth. On the other hand, women who grimace and clench their jaws while pushing have a greater tendency to tear, because their perineal tissues are more rigid.” (My first two births were these exact scenarios. With Madeline it was forced pushing, holding my breath with a clenched jaw. Got myself a 4th degree laceration. With Houston, I was in the water, mouth hanging open, hardly pushing, and didn’t tear at all).
• Here’s where you can practice. Next time you’re in the bathroom and things aren’t working as fast or as easily as you would like, open your mouth and let your jaw hang open. To help things along even more, make sounds “associated with pleasurable lovemaking.” I don’t mean re-enacting the night you conceived the baby, but low moans will work.

This is my favorite practical, preparatory book for pregnancy women. I tell everyone to read it and it is always first on the list when friends ask for recommendations.  If you’re pregnant, buy it. If you know someone who is pregnant, buy it for them.

Birth: The Surprising History of How We are Born

Tina Cassidy

This book is absolutely one of my favorites. It was probably the second book I read after finding out I was pregnant with Madeline (the first was Ina May’s Guide to Childbirth). It is not a “how to” book or a childbirth preparation manual. As the title indicates, it is a book about the history of childbirth. Here is a sampling of some of the things you will learn while reading this book:

• In 1954, Dr. Emanuel Friedman published the results of a study done as an obstetrics resident. While on a busy overnight shift he checked on all of the women in labor at regular intervals. His observations resulted in a bell-shaped curve that tracked the average length of time of the stages of labor. Ignoring the fact that there is a wide range of “normal” illustrated in the bell curve, doctors use the averages as “rigid benchmarks for how labor should progress. At the time Birth was published, Dr. Friedman was an emeritus professor at Harvard, “distressed and disappointed by how the curve is misused to diagnose a woman’s failure to progress, the most common reason American doctors list on charts to justify a c-section.”

• When birth first moved out of the home and into hospitals women were at grave risk of infection. Doctors, not yet aware of how disease passed from one source to another, often performed cervical exams on women without washing their hands between women or between handling corpses and pregnant women. A White House report published in the 1930s found that more hospital births was not resulting in less mortality for women or babies. “Equally shocking, infant deaths from birth injuries had jumped nearly 50% between 1915 and 1929.”

• As late as the 1970s the use of Scopolamine induced “Twilight Sleep” was still standard practice in some American hospitals for pain management.

I think we have all heard about how dangerous childbirth used to be and how so many women died giving birth. Before learning more about it I always thought that was just an inherent risk of having a baby. Turns out there are risks, but what I did not understand was why so many women used to die. It wasn’t just the act of having a baby; a lot of the risk came from caretakers intervening. Technology has been developed to make some of the danger go away. For example, compared to when doctors first started performing them, c-sections are much, much safer. We have medications and procedures to control bleeding and stop hemorrhaging. The question we have to ask ourselves, and the question this book repeatedly raises as it traces the history of birth, is, are we better off than we were before?

The author makes the point at the end of the book that childbirth is part of a continuum. It is interesting to look at where we are in the continuum and compare it to where we have been and then to imagine what the future holds. The author does not make those conclusions for the reader, and the book is objective. In some ways it might seem like she is advocating against the technology, but considering the relatively brief history of the interventions and procedures employed today it is clear that we cannot sit back and assume that where we are now is the end of the story.