Book Review: Giving Birth by Catherine Taylor

I found this book at a local sell-back store. I’ve found a number of books there marked down and just right for the library I’m building (most recently, Spiritual Midwifery by Ina May!!). I was not sure exactly what to expect from the book, as he subtitle on the front cover reads, “A Journey into the World of Mothers and Midwives“. Okay, I like the idea of a journey and any perspectives from the midwife’s point of view is one which I am always seeking.

I did not devour this book as quickly as I thought I would. First of all, the moment I began reading it I wanted to savor every word and en grain¬†the knowledge into my brain. I was hooked. Taylor is not a midwife, not a doctor…just a mom, doula, journalist and incredible writer. Secondly, Christian Grey made his way into my Kindle and well…I devoured him instead. ūüėČ

The very first quote I highlighted was in her forward called Beginnings.

When I arrived at my own childbearing years, I didn’t assume that I would or should have children, but I did have a sense¬†of entitlement to a birth experience that would include the highest-quality medical care, respect for myself as an individual, and¬†at least the potential for a transformative, spiritual experience. I had high expectations.

This quote rang in my ears as I pictured every pregnant mama out there and made a wish upon them that they too would have high expectations for their birth experience, no matter what that entailed. Taylor goes on to write in tandem as she interviews midwives, attends births, and gains her doula certification all while she herself is expecting her second child. There is a personal and professional balance between chapters that is very captivating and easy to identify with.

The medical model within the hospital and how midwives have to work within that model of rules and regs is one of the strongest pieces of this book. It identifies the struggles that each midwife feels and how their opinions are not always the same. Some midwives don’t mind the structure while others fight tooth and nail for their patient’s wishes. My eyes widened as I learned about a side of midwifery I had not thought about yet. This is a business, catching babies, and sometimes that business gets to make all the rules and you just have to follow them. After reading the details of how the hospital in which she was shadowing in ran their services and treated their midwives, I am certain that a hospital is not where I want to end up when the time comes for me to begin my career as a midwife. I want to work in a birth center.

Throughout the rest of the book, the reader is pulled into Taylor’s aches and pains of pregnancy, the rush of just barely making¬†it¬†to a birth, choosing the perfect midwife for her planned home birth, and witnessing a few scary moments with some patients. The writing is crisp and gripping. I highly recommend this book for anyone who is interested in becoming a midwife. I believe that is her true audience, however I could see a mama just wanting to learn more about midwives would benefit from this as well.

But if I can midwife the family through the birth, then that gift is going to go on after labor as well. It’s sort of that ‘teach a man to fish’ thing. ~Joanne, CNM

Book Review: Get Me Out

I’m finished with this book! I loved it. I loved learning so much about the history of childbirth, where and how certain procedures and assumptions came from and more. If you have any aspirations to work in women’s health then I highly recommend this book. Below are some more of my favorite quotes from the rest of the book. Please note that some of these quotes are not listed because I think they’re fact. Remember, these were assumptions for a very long time and some of them are laughable.

Jacobson said Sylvia had suffered from psychogenic infertility. In medical jargon, that translates to infertility caused by one’s psyche. In plain speak, it means your thoughts made you sterile. the thinking was that repressed fears and hostility derailed brain chemistry.

The corpus luteum is part of the ovary that makes progesterone during the second part of the menstrual cycle and prepares the uterine lining to implant the egg.

An NIH study in the mid-1960s compared 249 couples with unexplained infertility who adopted children with 113 infertile couples who did not adopt. Some 35 percent of couples who were infertile and did not adopt got pregnant without drugs compared with 26 percent of couples after adoption.

One article included an anecdote about a married female¬†lawyer who finally became pregnant¬†when she switched to part-time work. The doctor had this to say about her: “After her attitudes towards¬†herself changed, her pelvic physiology under went change and pregnancy then became a delightful anticipation rather than a hateful obligation”.

The researches did not say which came first, the depression/neuroses or the infertility, but it was assumed it was a brain-to-vagina route. A British study of 1000 women suggested that stress can clog fallopian tubes.

While each birthing guru preached a unique variant of natural childbirth, the underlying premise was the same: anxiety tenses muscles, and thigh muscles increase pain. Some researches taught women to relax muscles through exercise, some through meditation, some through religion.

Bing loathed the term “natural childbirth,” preferring the less-headline-grabbing but more meaningful sobriquet “prepared childbirth.” “Natural” sounded like a whole new approach, whereas “prepared” sounded as if they were simply informing you. Her mantra was “awake and alert.”

Unlike the English, who began to train nurses for midwifery, American doctors tried to get them off the playing field altogether.

A devout Christian, Dick-Read preached that the moment of birth should be a divine experience.

Dick-Read believe that perceptions influenced reaction. In other words, if you think childbirth is scary, you will tense your body and realize your fears.

Psychoneurotic women, he said, suffered during labor. Normal women gave birth easily. If one of his patients experienced a difficult birth, it was her fault for being a “selfish introverted woman.”

Yale would become one of the first US centers to launch a natural childbirth ward, thanks in part to a fortuitous confluence¬†of eager nurses, obstetricians, and pediatricians¬†swayed by Dick-Read’s dogma. It blossomed because of the young mothers themselves who demanded kinder, gentler births.

Wessle and the ladies pushed for rooming-in, the notion of having the baby stay in a bassinet with the mother rather than down the hall in a nursery.

One study found that 19.3 percent of 156 women who were coached for natural childbirth did not use any drugs at all.

Babies need to start as close as possible to mom for the mental well-being of both mother and child.

Maternal mortality dropped 70 percent from 1935 to 1948, and newborn deaths dropped by 40 percent.

Excessive bloating is a sign of preeclampsia, not a cause. These were the sorts of treatments that natural childbirthers would start to question. But the rest of the world was not ready for their scrutiny of medical authority.

One of the ongoing childbirth myths from antiquity right up to the 1950s was that dangerous things did not pass through the placenta or breast milk. That was nature’s gift to the perpetuation of the human race, or so it was thought.

Regarding the drug diethylstilbestrol (DES): The thalidomide saga shocked the world because it proved, for the first time, that drugs crossed the placenta.

A large meta-analysis of nine randomized controlled trials, including about 53000 women, found that continuous fetal monitoring was no better than using a stethoscope to hear the heart rate every so often. Several studies have shown that if a woman has a soothing caregiver by her side, labors tend to be shorter.

Cesarean section rates have increased by 46 percent in the past ten years without a comparable drop in maternal morality.

The fundamental philosophy of freebirthers is that female humans would give birth more easily if, like their nonhuman primate friends, they chilled out and if, again like their nonhuman primate friends, they were not surrounded by all the fuss of medical monitoring and doctors and midwives.

The upshot: women with doulas had shorter labors, 8.8 hours versus 19.3 hours, and were less likely to have cesarean sections, 19 percent versus 27 percent.

Ultrasound is energy, High doses are sued to heat and heal muscle injuries. It is used in other countries, but not the US, as an alternative treatment¬†for cancer. If it’s therapeutic-or¬†if it’s changing muscle physiology somehow-there is a chance that it could affect the baby, particularly¬† at excessive doses for a long time. Doctors say that the¬†low dose¬†used for a few exams¬†during pregnancy are safe, that the benefits outweigh any potential risk. They worry about excessive doses for long periods.

Artificial insemination is not new, but turning what had been a secretive medical treatment into a moneymaking business is.

Specific enzymes at the head of the sperm digest an outer portion of the egg, permitting entrance. It is called the acrosomal reaction.

Sperm swim about 30 micrometers per second, which means it would take a sperm 10 minutes to swim across the period at the end of this sentence.

It was not just the experiment¬†but Sim’s newfangled notions about making babies that enraged the medical community. Women who got pregnant while knocked out with ether debunked the long-held notion that a couple needed simultaneous orgasms to make babies. He wrote that if great sex were necessary to make babies, humans would be fossils by now.

Book Review: Get Me Out (Part 1-2)

(A note: I KNOW this is long. Please, if you have any interest in this subject, read through. I add several direct quotes from the book which I feel are important. Thank you for checking it out! If you’ve read this, please leave your thoughts in the comments and if you haven’t, well, you should!)

I have been so excited to share this book with you guys! It wasn’t even on my reading list (see tab above) and as I was checking books out over the weekend I found this little gem.

Get Me Out¬†was written by Randi Hutter¬†Epstein, MD and is a comical, factual, and historical account of the history of childbirth “from the Garden of Eden to the Sperm Bank” as the front cover reads. As most of you readers out there are childbirth guroos like myself, you may also know of Abby Epstein, co-author of Your Best Birth with Ricki Lake. I have yet to find any credible resource that these two are related somehow, however I would not be surprised if they were.

This post is only to summarize¬†and discuss the first two parts of the book (I just couldn’t wait!) as I am still reading it. The book starts off with a lot of history in regards to how the concept of childbirth came about. Many believed that labor pains¬†were “the curse of Eve” since she ate that damn apple. Regardless of your spiritual beliefs, the book does an excellent job of bringing forth history which most have never even heard of and most of which is rather comical. For example, many believed that “good sex made for good babies” but no one really defined what “good sex” was, just that if you had a “good baby” then you must have had “good sex” at conception.

Epstein goes on to discuss how childbirth tools came about, specifically¬†forceps and the speculum. and how the inventors of those tools were mearly¬†trying to prevent internal damage to the woman, specifically vesicovaginal¬†fistulas (holes/tears) from childbirth. It’s disturbing to read that these doctors tested out their new inventions on slaves because if a woman was so damaged during childbirth, then she was useless to her owner and breeding more slaves was an important aspect to maintaining the plantation.

Homebirth¬†was the only way women gave birth hundreds of years ago and historically, no man was allowed in the birthing room. Only midwives and her supporters (sisters, mother, etc). A male doctor once dressed as a woman and entered the birthing room.¬†Once he was discovered he was killed. Seriously?! It’s this kind of history that has me hanging on every word in the book, to think that men were truly not allowed and today, thousands of male OBs practice and treat women. Wow.

Maternal and infant mortality is discussed quite a bit, mostly in regards to how the birth was handled as men seeped their way into the birthing room. Doctors never washed their hands before seeing patients, causing a huge rise in deaths to mothers from childbed fever. It was very common for a doctor to see a patient to her death and go into the next room to deliver another baby and passing on infection to both. Even in the early 1900s hand-washing was still not believed to prevent the spread of infections.

At the turn of the 20th century, the ideas of a Lying-In hospital began to open up across the country, the new birth place for women. Women were told that there was nothing safer than giving birth at the Laying -In hospital, despite the maternal mortality rate staying the same for several years due to lack of hand-washing, among other things (uneducated doctors, student-doctors, misuse of tools, hemorrhaging, etc).

Lastly, twilight sleep. I had never heard of this form of childbirth until now. Women were fighting for their rights in the early 1900s and one of those rights was to give birth without pain (which is ironic today, since natural, med-free childbirth is harder to push for). Two docs put an odd concoction of drugs together (morphine and scopolamine) and within a few hours the mother was not pain-free, but “awoke” hours later to find that she’d had her baby and had no recollection of the pain when in fact she was writhing in pain, being restrained to her bed and treated like a wild animal. Yeah, nuts I tell ya.

As I like to do with all my reviews, here are my favorite notations so far (chronological from the beginning of the book through part two):

(Middle Ages) One guide-book told women that getting pregnant was the same as catching a serious disease-an opportunity to die.

When do you call for extra measures and when do you let nature take its course? It’s a debate that began in the late sixteenth century but resonates loudly and clearly into the twenty-first.

Sims was not the first person to do vaginal-tear experiments on slaves. But he was the first one to do it successfully and the first one to turn his procedure into global fame and fortune. Fifteen years before Sims did his trails, Dr. John Peter Mettauer tried the same kind of thing on several slaves, but he used lead sutures instead of silver.

There was no such thing as informed consent-or any kind of consent, informed or otherwise.

Sims used his newest invention, the speculum, made from two large spoons he picked up at the local hardware store.

He created the so-called Sims position: placing a woman in a fetal position to make it easier to look inside.

Sometimes doctors went from autopsy to delivery, back and forth-death to birth, birth to death, chaffering germs with them. Long before doctors eyed bacteria or knew anything about them, a few scientists suspected contagion. They did not know what was spreading but had a hunch something awful was passing from one sick new mother to the next.

The hand that is relied upon for succor in the painful and perilous hour of childbirth becomes the innocent cause of her destruction.

Then Semmelweis reasoned that doctors who perform autopsies before delivering babies carried something deadly from the morgue to the delivery room. He was proposing a sort of germ theory without knowing anything about germs. His colleagues saw otherwise. They saw a young arrogant doctor claiming that doctors were murderers.

The germ theory provided one reason for illness, but it was at odds with several other well-rooted theories.

Joseph Lister discovered that carbolic acid destroyed germs lurking in wounds; he named his cleaning technique antisepsis. And Rober Kock devised a four-step program to prove, without a shadow of a doubt, that germs triggered illness.

Kochk’s four steps: 1) The bacteria must be present in every case of the disease, 2) the bacteria must be isolated from the host with the disease and grown in pure culture, 3) the specific disease must be reproduced when a pure culture of the bacteria is inoculated into a healthy susceptible host and 4) the bacteria must be recoverable from the experimentally infected host.

Events during the turn of the twentieth century proved that germs caused the disease; that doctors passed the infection to patients; and that antiseptic technique (scrubbing between patients) prevented infections.

About 8 mothers died for every 1,000 births.

By the turn of the twentieth century, doctors accepted the idea that germs caused childbed fever. But for the next few decades, many of them could not accept the idea that they carried the germs.

They promoted an autoinfection¬†theory, insisting that new mothers got sick by ‘infecting or by the spread of an inherently bacteriologically fertile reproductive organs’, aka endotoxin theory (a toxin growing from within).

Eventually, other studies would make it crystal clear that pregnant women may be more susceptible to colds and flu, but the pregnant womb does not grow its own garden of bacteria. The endotoxin theory died. The only way a women got childbed fever was by having a contaminated band or instrument inserted during delivery.

They (doctors) believed they were saving lives by luring women away from midwives and into the hospital, where doctors could control the business of babies. Ironically, what they thought was the best medical care was sometimes the deadliest.

They (doctors) hoped the buzz about the reopening of the Laying-In hospital would dissuade women from going to midwives.

In 1900, 5 percent of women gave birth in hospitals. By the 1930s, about half of all women and 75 percent of women in cities delivered in hospitals. And by the 1960s, nearly every pregnant woman chose a hospital birth over a home birth.

The feeling among most women was that if you wanted to survive childbirth, you were better off at home and far away from maternity wards.

It was not only a move from home to hospital, it was a move from one culture to another, from the familiar to the strange. It meant you were on doctor’s turf.

In 1900, a baby was born in New York City every 10 minutes.

Doctors believed that women needed to be in the hospital to get the best care in the cleanest surroundings. They also knew that a hospital birth spared them from running from house to house.

Dammerschlaf, or twilight sleep, as it would become known in America, provided women with drugs during labor that lulled them into a woozy forgetfulness during the birth of the baby.

The added amnesia meant that women felt pain but forgot about it-which makes you wonder if anything is painful if there is no memory.

Sheppard-Tower Maternity and Infancy Protection Act, a federal program that gave grants to states for prenatal and child health clinics. The act also provided funding for nutrition and hygiene education, midwifery training, ad home visits by nurses to check on pregnant women.

The Twilight Sleep Association illustrates, perhaps more than any other turn-of-the-centurey organization, the zeal of the early feminists; the simmering anger toward male doctors; and the power of the media to shape public opinion.

Yet there were plenty of doctors who thought that women who could not bear the discomfort of childbirth could not withstand the selflessness of motherhood.

Drug advocates convinced women that taking medicine was not a sign of weakness but was healthier for themselves and their newborn.

Childbirth drugs diminished uterine contractions and caused hallucinations. It also impared newborn breathing. Doctors  called it newborn oligopnea, halted breathing. The doctors reassuringly added that while some twilight babies stop breathing for a bit, they never turn blue.

A Long Island doctor wrote a letter to the editor of the New York Times calling its twilight-sleep stories an ‘unprofessional and dangerous way of misinforming the public’.

Forgetting the moment of birth should not make any difference whatsoever on the kind of mothers these women would become. Epidurals, which remove pain but allow women to be alert, were a long way away.

Book Review: The Womanly Art of Breastfeeding

Below is my review of this book, written by a number of women affiliated with La Leche League International. This was one of three other books I picked up from the library on breastfeeding. I’d also picked up The Nursing Mother’s Companion by Kathleen Huggins and The Ultimate Breastfeeding Book of Answers by Jack Newman. I’ve heard great things about each book. Honestly, I’m a Q & A type of person. I enjoy reading books on certain subject in a Q & A format. I thought for sure that would be how the latter book would present, but it didn’t and I was instantly turned off. I may pick up these books again when I’m going through my lactation consultant training (in March, I hope!).

The format of this book is great. Each chapter is laid out by ages and stages in nursing, beginning with pregnancy. The reader learns the basics about hormones, milk production, and nursing positions within the first 100 pages. That being said, this book is wayyyyyyy too long! BUT, do not let that stop you from reading it.

Each chapter addresses the same things for that age: Nursing Habits and Concerns You May Have. I found these sections the most informative. There is a Q & A type style weaved in, like “Is my supply dropping? Is my baby weaning?”. At the end of the book, Chapter 18, is a tech support guide to helping the reader figure out what she needs to do next. It addresses things like reflux, sore nipples,supplementing, etc. If the reader is looking for quick answers, there is a glossary in the back of the book that can be very helpful.

Because the book is written by the #1 breastfeeding support organization in the world, there is a lot of credit to be given. If you’re looking for one book to take you through nursing a newborn to a toddler, then this is a great resource. You’ll only need it for 1-2 chapters as it covers 4-9 months quickly and as situations come up, the glossary is available. As the book suggests, having a network of support is a surefire way to make nursing much easier, even through the bleeding nipples and thrush. Find out if your hospital offers a program for new nursing mothers; ours does. I was there nearly every week while I nursed Logan.

As with any self-help book, there are certain things you may want to take with a grain of salt. This is a very one-sided representation of breastfeeding. I had to roll my eyes a few times. Don’t let certain assumptions expressed stop you from reading and/or seeking help through nursing. The mama who can continue to nurse after a bought with mastitis is my hero!

I made note of several lines in the book which were helpful. Here’s a sample:

Living cells that are unique to your milk inhibit the growth of harmful bacteria and viruses in his still-maturing system. And it’s more than just living cells. For instance, interferon and interleukins are powerful anti-invectives. If you could buy them, they’d cost the moon. Your milk throws them in, free of charge. A squirt of your milk can even treat eye infections and speed the healing of skin problems!

Colostrum is a laxative that gets his intestines up and running and helps clean out all the tar-like stool called meconium that built up in his system before birth.

Breastfeeding doesn’t reduce the risk of infection, illness, and disease. It doesn’t add IQ points. Breastfeeding results in normal good health and normal IQ. When babies aren’t breastfed, they are at increased risk for those short-term and long-term illnesses and diseases.

These hormones, prolactin and oxytocin, not only foster a connection with your baby, they also help you recover from the emotional and physical stress of birth.

Nipple sensitivity is common in the early days. But if breastfeeding actually hurts, that’s your body’s single to change something.

Nipple pain and damage are NOT normal.

Once you start, milk is always being made. It’s made more rapidly when the breast is less full. The fuller the breast, the more slowly milk is made.

Most important, decide this is something you are GOING to do, not something you are going to TRY to do.

If you read this and write a review, please leave a comment and link! Thanks.

Book Review: Labor of Love by Cara Muhlhahn

Labor of Love: A Midwife's Memoir

Earlier this week I hopped on my bike and headed to the library. I had two books in mind and this was one of them. At first glance I did not realize that this is the Cara whom was the featured midwife in The Business of Being Born and the moment I realized this (as the forward is written by both Ricki Lake and Abby Epstein) I was hooked. I knew I’d love this memoir before I’d finished the first chapter.

I’ve tried now for several days to find the right words to summarize this book but I’m at a loss. Though she does not make any mention of it in her book, Cara should add “inspiring writer” to her resume. Throughout the memoir you never get the impression that Cara had any intentions of writing about her journey into midwifery but because of the unexpected fame that The Business of Being Born¬†has brought her she was able to put into words everything I was wanting to know. Cara’s words are humbling. She is the¬†epitomie¬†of the kind of midwife whom¬†I would a) want to help me deliver my next baby and b) aspire to become someday. (No, I have no fantasies of becoming a home birth midwife.)

As a whole, this memoir is exactly what every aspiring midwife should read, even if home birth midwifery is not your ultimate goal. It’s not mine. In fact the thought of a home birth is both¬†nerve-racking¬†and thrilling at the same time. Cara’s perspective is so genuine and even I have softened up to the idea of a home birth-maybe.

The memoir begins with Cara sharing her life before midwifery and while I was taken aback at first as to why this was important in a memoir about being a midwife, her childhood and early adulthood shaped her into the kind of midwife she is today. Without giving too much away, her early adulthood included traveling all over the world, being sucked into a cult in California, being kidnapped by her parents and ultimately having her very own child via home birth.

Cara gave the most honest¬†portrayal of a controversial career in midwifery that I’ve ever read. Midwifery is not accepted and welcomed in our society the same way it is in other countries all over the world. Cara has experience working in a hospital, birth center and independently¬†in home births. Being well-rounded in each area of birth makes what Cara does even more valid. She has the research and knowledge¬†to help guide any mama, whether she is totally comfortable with a home birth or not, in the right direction going as far to say that she does not hesitate to suggest hospital births to those mamas who are no where close to being comfortable with a home birth. This honesty is what makes the book so real. There is not one ounce of it in which I thought, “really? I don’t know about that…”.

As a mother myself, one of the greatest aspects of the memoir is how she does not hold out on how difficult it is to be on call 24/7 and manage being a mom at the same time, even admitting¬†that the pager does in fact come before her son. WOW! Can you even imagine how difficult that must have been to admit? That someone else is more important than your own flesh and blood…I was floored. I have since stopped saying any “I have/will nevers” when it comes to being a wife and mom but I do hope and pray that I don’t ever admit those stinging words. This is one of the biggest reasons why I am certain home birth midwifery is not for me. I NEED a schedule and as long as it includes still being a wife and mom then I am okay with that.

After reading this book there is no doubt in my mind that Cara was always meant to be a midwife as I feel there is little to no doubt in my mind I want to become one as well. There are still a million questions I would love for her to answer but I suppose that will have to wait.

Review: Ina May’s Guide to Childbirth

I just finished ready Ina May’s Guide to Childbirth¬†by none other than Ina May Gaskin. I’m sure I am not the first to say so, but I believe she is the Mother Teresa of Midwifery. Truly inspiring. I’m so glad to have read this book AFTER I had a baby and am currently not expecting. The point of view one takes from that perspective is so different from¬†when you are expecting and have hormones all over the place. That is not to say that if you are expecting that you should not read this. YOU SHOULD READ THIS! This book is inspiring, honest, educational, and totally biased towards natural, unmedicated births.

The first half of the book contains birth story after birth story and if you’re anything like me then you will love reading them. While I was pregnant I read hundreds of birth stories, mostly to encourage me that my body was made to give birth. I had a lot of fears and even knew first hand from friends how quickly things can go array. All of the birth stories take place at Ina May’s farm in rural Tennessee. Sounds a little hippy, a little fairy-tale, a little poetic, but very real all the same. Reading the birth stories even after I’d had Logan has been just as encouraging for me to continue my slow road to midwifery.

The second half of her book is very technical. She talks about each stage of labor, how you can manage pain, what and how our bodies are designed to give birth and general stats. The stats are overwhelming and almost dated at this point, but interesting nonetheless. As I recommend this book to expecting moms I also want to encourage you to take certain things with a grain of salt. Ina is a little out there (aka: birth being sexual?! gasp!!) BUT there are very concrete explanations behind her theories.

As a way to make a note for myself and to highlight pieces worth sharing I am listing below what I find useful. I love that my Kindel has this highlight/bookmark feature! As a way of saving me some extra work I think it goes without saying that everything is a direct quote from Ina May’s Guide to Childbirth and that I am giving credit to her and her alone.

Our rule of thumb in guiding women through labor is to let the mother choose her own way of giving birth.

Thin women don’t seem to have the muscle mass to resist what labor is trying to do that sturdier women have. Of course there are always exceptions.

I learned that true words spoken can sometimes relax pelvic muscles by discharging emotions that effectively block further progress in labor.

All women are sensitive. Some women are extraordinarily so. We learned this truth by observing many labors stop or slow down when someone entered the birth room who was not intimate with the laboring mother’s feelings. If that person then left the room, labor usually returned to its former pace or intensity.

Remember this, for it is as true as true gets: Your body is not a lemon. You are not a machine. The Creator is not a careless mechanic. Human female bodies have the same potential to give birth well as aardvarks, lions, rhinoceros, elephants, moose, and water buffalo. Even if it has not been your habit throughout life so far, I recommend that you learn to think positively about your body.

During the last few days of pregnancy, hormones called prostaglandins cause the thick cervical muscle to begin to soften and thin in readiness for labor. This process is called ripening.

Prostaglandins, oxytocin, adrenaline, and endorphins are some of the most important natural chemical combinations produced within the woman’s body during labor and birth.

French physician Michel Odent calls my sister’s experience an example of the fetal ejection reflex-a sudden rise in adrenaline gives us the surge of power necessary to complete the job of birth.

We need to always remember that mothers who are afraid tend to secrete the hormones that delay or inhibit birth. This is true of all mammals and is part of natures design.

‘Don’t worry’ I’ll say. ‘I’ve never seen anyone explode or tear in half.’ Relief is usually instant and complete. ‘Only the baby will come out,’ I’ll go on if I notice my words are having a calming effect. ‘Your body is very wise. It only pushes out what needs to come out.’

They usually aren’t¬†aware of the extent to which you can ease your own¬†tense reaction¬†by declining to think in terms of ‘uterine contractions’ and thinking instead of ‘interesting sensations that require all of your attention.’

One of the most meaningless diagnoses in obstetrics is cephalo-pelvic disproportion (CPD), a term based upon the Three Ps theory-the baby being too big to fit through the maternal pelvis. The rate of CPD varies widely from hospital to hospital, as well as from country to country. My partners and I have attended successful vaginal births for many women who were previously diagnosed with CPD.

To qualify as a law of obstetrics, a description of a biological truth ought to be true all of the time, not just occasionally.

The neocortex-the newer, rational part of the brain, which plays a role in abstract thought-and the primitive brain, which governs instincts. The primitive brain, or brain stem, is also considered to be a gland that releases hormones. All female mammals, including humans, release a certain number of  hormones such as oxytocin, endorphins, and prolactin in the process of giving birth. Stimulation of the neocortex, on the other hand, can actually interfere with the birth process by inhibiting the action of the primitive brain in hormone release.

If it becomes necessary to gain entrance to a vaginal, cervical, or anal sphincter, it is a much less unpleasant experience when certain principles are kept in mind: (summarized) permission must be asked, place finger gently on rim of sphincter and hold for 4-5 seconds, move inside slowly and gently.

Out of these very different conceptions of women’s bodies and the meaning of birth have come two separate models of maternity care: the midwifery or humanistic model of care and the techno-medical model of care.

The midwifery model of care recognizes the essential oneness of mind and body and the power of women in the creation of new life. The midwifery model of care conceives of pregnancy and birth as inherently healthy processes and of each mother and baby as an inseparable unit.

Chorionic villus sampling (CVS) is an invasive technique for testing for chromosomal abnormalities. It is done before twelve weeks. It’s main advantage is that it can be done earlier in pregnancy than an amniocentesis.

The glucometer is a finger-poker that measure the sugar levels in a drop of blood. We use it when we notice several of the following symptoms at twenty-eight weeks or thereafter: (summarized) fast weight gain, feeling ‘funny’ or ‘dizzy’ after meals, constant thirst, craving for sugar, family history, previous large baby.

Certain situations are associated with a higher risk of infection in the baby. These include: (summarized) low birth weight or premature babies, membranes ruptured for more than 18 hours before birth, long labors, interventions, fast fetal heart rates, mother developing fever, high beta strep colonization in vaginal culture, and babies who need resuscitation at birth.

Inform yourself about what you will and will not accept. US courts have accepted the idea that you give your implied consent to procedures if you have not actively objected to various procedures by simply refusing them, firing your caregiver, or discharging yourself from the hospital against medical advice.

It may help to know that labor often starts and stops a time or two before it becomes powerful enough to complete the birth process.

There are legitimate medical reasons for induction. These include cancer, hypertension, diabetes, kidney disease, a small-for-dates baby, a decrease in the amount of amniotic fluid or an intrauterine death followed by a long wait for labor to begin (we’re talking weeks, not days).

The most common medical methods used to induce labor are breaking the waters (amniotomy), and various chemical methods: Pitocin IV drip and the administration of various prostaglandins (Cervadil, Prepidil, and Cytotec).

Given this history, it is not an exaggeration to call the supine position an invention of the industrial revolution.

Shaking the large muscles of the mother’s bottom or thighs is an effective way of helping some women relax during labor.

The technique, called the ‘pelvic press,’ involves putting pressure on the upper part of the woman’s hips (the upper iliac crest) while she pushes. This pressure pinches her hip bones closer together at the top while opening them a corresponding amount at the bottom, thus freeing the stuck head.

The hula and other hip-swinging dances of the Pacific island nations, Middle Eastern belly dancing, and rhythmic butt-shaking dances of Africa are all examples of dances that strengthen the pelvic muscles.

Episiotomies: cause pain that lasts for week or months, increase blood loss, cause more serious tears, often become infected, damage to pelvic floor muscles, and prevent women from breastfeeding due to pain.

Studies have shown that delayed cord-clamping allows between twenty and fifty percent of the baby’s blood volume to flow into the baby. Early cord-clamping also results in lower hjematocrit¬†or hemoglobin values in the newborn (fewer red blood cells). Midwives agree that premature babies especially benefit from later cord-clamping.

At some point we will apply antiseptic to the baby’s cord stump and inspect the baby, but all this can happen at the convenience of the mother and baby. They are doing something more important just by being together. They are falling in love.

Step one to preventing postpartum depression (PPD) is to find time to sleep after giving birth, no matter how euphoric you feel. Try to sleep as much as you can when your baby sleeps.

See resources for a video documentary about Mrs. Smith, which aired on TV in 2002.