Ina May Gaskin

A very readable, engaging, and concise primer on why birth matters and what's going wrong with it in the contemporary US.

Gaskin speaks here to a broad audience--parents and people with no interest in having children, women and men, people with significantly different political perspectives and approaches to birth / parenting / reproductive rights. Birthing Matters articulates what so many of us in the birth advocacy world want people to hear: why our culture's views and treatment of show more pregnant/birthing/breastfeeding women should matter a great deal to you whether you personally are a woman or pregnant/birthing/breastfeeding (especially if you're a feminist and/or claim to care about human beings). Here, Gaskin sets aside the more overtly gender-essentializing language and emphases of some of her other work (which seems to be aimed at a narrower readership), presumably to focus on areas of broad interest: for instance, her call to reduce pregnancy/birth-related deaths in part by creating a meaningful system of reporting and reflecting on the maternal deaths that do happen. It really would be hard for anyone to say, 'No, I like it when women die needlessly in childbirth, and I don't think we should bother keeping track,' right?

The chapter about and addressed to fathers-to-be is actually quite good: I was nervous because I know how awful most just-for-dads writing is! But why "fathers"? Everything she says here is equally useful and relevant for women who are birthing women's partners. The book, troublingly, seems to assume that everyone's straight and everyone's cis-gendered. These oversights seem especially out of place given the book's otherwise inclusive, respectful, and loving tone. show less

Between this and [b:The Mama Natural Week-by-Week Guide to Pregnancy and Childbirth|29430619|The Mama Natural Week-by-Week Guide to Pregnancy and Childbirth|Genevieve Howland|https://i.gr-assets.com/images/S/compressed.photo.goodreads.com/books/1488107243l/29430619._SX50_.jpg|49695208], I get the vibe that "natural" childbirth books do make pregnant folks feel less fearful about birth in general... while also instilling a fear of the medical profession and interventions, which I find less show more productive. Your mileage may vary. This was lent to me by a friend.

The first half is entirely anecdotes by parents who mostly birthed at The Farm commune in Tennessee or had midwife-attended/influenced births. Many of them are from the 1970s and 1980s, with the most recent being around 2000 (which makes sense since this was published in 2003). Still, a little disconcerting to read about births for people older than me...

...the temporal nature also applies to how I feel about the second half. In the twenty years since this was published, I do think the profession has changed- the American c-section and maternal mortality rate is still high compared to the rest of the world, but there's far more baby-friendly (per WHO rules) hospitals, including the one I plan to deliver at. When asked about birth preferences last week I mentioned wanting to avoid an episiotomy if I can, and two different docs mentioned that it's been years since they've seen one done at my local facility. Likewise, the chapter "What You Need to Know About Your Pregnancy and Prenatal Care" dismisses most screening/testing as Ina May believes they tend to lead to unnecessary interventions and... this strikes me as irresponsible, though NIPT (nonexistent in 2003) is definitely less invasive than amnio or CVS (and as someone with a genetics background, OF COURSE I was going to do testing!! It's really interesting!!)

I also have a gestational diabetes diagnosis. She thinks that "the anxiety that is often produced by [the glucose tolerance test] simply isn't worth the information gained from it. Sometimes, when the test is positive, you may be urged to undergo further expensive tests and treatments with no proven benefit" and goes on to say that sometimes women feel funny and have high sugar readings that wouldn't be detected by testing, usually because they ate something that they don't tolerate well during pregnancy, like white flour and sugar which should be eliminated from the woman's diet... ma'am, that's literally what's suggested as a GD treatment!! It would not have been on my radar if I hadn't done two different glucose tests, because while I do have some family history I don't get dizzy spells from sugar.

In short, while Ina May is probably right that avoiding screenings and tests will reduce anxiety, it does create the potential situation of going into birth blind to potential complications until it's possibly too late. I prefer knowing what's going on and the likelihood of future events. Modern medicine doesn't solely exist for profit; as someone who was a premature baby (my mom's water broke weeks early, and she was an older first time mother), I have a healthy respect for interventions as I probably wouldn't be here otherwise! I'm curious if Ina May's ever considered updating or revising this, or if it will be a snapshot of perspectives from the early 2000s after 40 years in the business.

Also: you're going to see photos of crowning babies coming out of labia in this book, just be forewarned! Fascinating, but just a heads up (heh). show less

The midwife lent me a whole stack of books (and is always pushing me to take more), but so far the only one I've read cover-to-cover is this one. And I'm wishing I'd read this before I had Jefferson.

Roughly the first half of this book is birth stories. Almost all of them are midwife-assisted births at The Farm, a village/commune in Tennessee, mostly just in homes without a lot of special equipment. Very few of the births had to be transported to the hospital, though those are represented as show more well. The stories are testament to what a calm and experienced birth assistant, a trust in the power of a woman's body, and the natural process of birth itself can do -- even when the mother gets temporarily hung up by fear, even with extremely large babies, and even with some fairly troublesome complications.

The second half of the book is a collection of essays by Ina May on the current state of birthing in the United States. (Primarily it's about this country anyway, there is also a lot of data from other countries for comparison.) The latter chapters are sometimes hopeful, sometimes chilling, but mostly make me glad we're trying for a midwife-assisted home birth this time.

But this book is mostly famous in our house for two pictures of a face-presentation. Jefferson was looking over my shoulder one day as I was reading this book and liked all the pictures of babies. So I started flipping through it with him looking for the pictures. Most were standard mom and baby post-birth posed shots, but on page 58 there is a picture of a baby where only the face has emerged from the birth canal, and then another of the baby right after delivery, with its poor face all smooshed and swollen. I was a little worried about Jefferson's reaction, as I hadn't intended to give him quite such a graphic introduction to "where babies come from," but he loved the pictures, and for a while developed a nightly routine of wanting to see the baby pictures before bed. At one point he even indicated the face presentation and told me he wanted me to have that baby. I told him no matter how much I loved him and wanted him to be happy, I would never wish for a face presentation.

Anyway! I loved this book. Very authoritative and informational. Would recommend to anyone interested in a more natural version of childbirth. show less

Although this book contains much factual information about pregnancy and childbirth, Ina May's Guide to Childbirth is just as much a book on childbirth philosophy as it is a book about the process of birthing a baby.

The heart of the book is a number of birth stories, sometimes in the words of the women who gave birth and sometimes in the words of Ina May. While some of the women further toward new age woo than I think is quite reasonable, for the most part, these are powerful stories of show more women finding in their bodies and minds the power to give birth in a way that doesn't treat birth as a medical problem to be fixed. One thing I appreciate about these stories is that they don't exclusively describe normal, uncomplicated births. A good handful of the stories contain births that were difficult.

One thing Gaskin does well is demonstrate how many of the birth interventions that are sold as conveniences can hamper birth and lead to further interventions that the woman did not originally want. For example, the labor inducing drug Pitocin (synthetic oxytocin) can force the body into labor before the pelvic region has finished preparing for birth which, in turn, leads to higher levels of cesarean sections. This isn't to say cesarean sections are bad. The point is that a woman may choose one intervention — induced labor — and end up with another which she may not have personally wanted — a cesarean section. Another example is epidurals to kill the pain of birth can lead to higher levels of perineum tears because the woman giving birth is unable to feel when she is pushing too hard or too fast.

Because of this, Gaskin advocates letting women's bodies do their work and turn to interventions only as needed. The medical interventions that doctors have available to them today are wonderful lifesavers, but by treating them as conveniences that can standardize birth, we start down a chain of interventions in way that are not always desirable.

Beyond the philosophy, this book also contains a lot of information about the birth process that emphasizes how to let the process of birth happen in its own way: let the birth take time; stand up and move around to help the baby into the right position and let gravity help you push it out; laugh or let your partner sexually stimulate you to relax you and help to loosen your muscles; etc. These aren't magical incantations to make the birth process pain free and fast, but they are ways of working with the birth process rather than against it.

You shouldn't read this book expecting a neutral presentation of non-medical birth, but you should read it if you want a book that focuses on birth as a normal process not something to be medicated away. show less